Total artificial heart implantation in a young Marfan syndrome patient.

PubMed

Rao, Prashant; Keenan, Jack B; Rajab, Taufiek K; Kim, Samuel; Smith, Richard; Amabile, Orazio; Khalpey, Zain

2018-03-01

Cardiovascular complications represent the leading cause of morbidity and mortality in patients with Marfan syndrome. Here, we describe a unique case where a total artificial heart was implanted in a young Marfan syndrome woman. A 22-year-old postpartum African American female with Marfan syndrome developed multiple severe valve dysfunction and biventricular failure that was refractory to medical management. She previously had a Bentall procedure for Type A aortic dissection and repair of a Type B dissection. We implanted a total artificial heart with a good outcome. Total artificial heart is a durable option for severe biventricular failure and multiple valvular dysfunction as a bridge to transplant in a young patient with Marfan syndrome.

FLUID MECHANICS OF ARTIFICIAL HEART VALVES

PubMed Central

Dasi, Lakshmi P; Simon, Helene A; Sucosky, Philippe; Yoganathan, Ajit P

2009-01-01

SUMMARY 1. Artificial heart valves have been in use for over five decades to replace diseased heart valves. Since the first heart valve replacement performed with a caged-ball valve, more than 50 valve designs have been developed, differing principally in valve geometry, number of leaflets and material. To date, all artificial heart valves are plagued with complications associated with haemolysis, coagulation for mechanical heart valves and leaflet tearing for tissue-based valve prosthesis. For mechanical heart valves, these complications are believed to be associated with non-physiological blood flow patterns. 2. In the present review, we provide a bird’s-eye view of fluid mechanics for the major artificial heart valve types and highlight how the engineering approach has shaped this rapidly diversifying area of research. 3. Mechanical heart valve designs have evolved significantly, with the most recent designs providing relatively superior haemodynamics with very low aerodynamic resistance. However, high shearing of blood cells and platelets still pose significant design challenges and patients must undergo life-long anticoagulation therapy. Bioprosthetic or tissue valves do not require anticoagulants due to their distinct similarity to the native valve geometry and haemodynamics, but many of these valves fail structurally within the first 10–15 years of implantation. 4. These shortcomings have directed present and future research in three main directions in attempts to design superior artificial valves: (i) engineering living tissue heart valves; (ii) development of advanced computational tools; and (iii) blood experiments to establish the link between flow and blood damage. PMID:19220329

Fluid mechanics of artificial heart valves.

PubMed

Dasi, Lakshmi P; Simon, Helene A; Sucosky, Philippe; Yoganathan, Ajit P

2009-02-01

1. Artificial heart valves have been in use for over five decades to replace diseased heart valves. Since the first heart valve replacement performed with a caged-ball valve, more than 50 valve designs have been developed, differing principally in valve geometry, number of leaflets and material. To date, all artificial heart valves are plagued with complications associated with haemolysis, coagulation for mechanical heart valves and leaflet tearing for tissue-based valve prosthesis. For mechanical heart valves, these complications are believed to be associated with non-physiological blood flow patterns. 2. In the present review, we provide a bird's-eye view of fluid mechanics for the major artificial heart valve types and highlight how the engineering approach has shaped this rapidly diversifying area of research. 3. Mechanical heart valve designs have evolved significantly, with the most recent designs providing relatively superior haemodynamics with very low aerodynamic resistance. However, high shearing of blood cells and platelets still pose significant design challenges and patients must undergo life-long anticoagulation therapy. Bioprosthetic or tissue valves do not require anticoagulants due to their distinct similarity to the native valve geometry and haemodynamics, but many of these valves fail structurally within the first 10-15 years of implantation. 4. These shortcomings have directed present and future research in three main directions in attempts to design superior artificial valves: (i) engineering living tissue heart valves; (ii) development of advanced computational tools; and (iii) blood experiments to establish the link between flow and blood damage.

Perioperative Care of the Patient With the Total Artificial Heart.

PubMed

Yaung, Jill; Arabia, Francisco A; Nurok, Michael

2017-05-01

Advanced heart failure continues to be a leading cause of morbidity and mortality despite improvements in pharmacologic therapy. High demand for cardiac transplantation and shortage of donor organs have led to an increase in the utilization of mechanical circulatory support devices. The total artificial heart is an effective biventricular assist device that may be used as a bridge to transplant and that is being studied for destination therapy. This review discusses the history, indications, and perioperative management of the total artificial heart with emphasis on the postoperative concerns.

Domestic and foreign trends in the prevalence of heart failure and the necessity of next-generation artificial hearts: a survey by the Working Group on Establishment of Assessment Guidelines for Next-Generation Artificial Heart Systems.

PubMed

Tatsumi, Eisuke; Nakatani, Takeshi; Imachi, Kou; Umezu, Mitsuo; Kyo, Shun-Ei; Sase, Kazuhiro; Takatani, Setsuo; Matsuda, Hikaru

2007-01-01

A series of guidelines for development and assessment of next-generation medical devices has been drafted under an interagency collaborative project by the Ministry of Health, Labor and Welfare and the Ministry of Economy, Trade and Industry. The working group for assessment guidelines of next-generation artificial hearts reviewed the trend in the prevalence of heart failure and examined the potential usefulness of such devices in Japan and in other countries as a fundamental part of the process of establishing appropriate guidelines. At present, more than 23 million people suffer from heart failure in developed countries, including Japan. Although Japan currently has the lowest mortality from heart failure among those countries, the number of patients is gradually increasing as our lifestyle becomes more Westernized; the associated medical expenses are rapidly growing. The number of heart transplantations, however, is limited due to the overwhelming shortage of donor hearts, not only in Japan but worldwide. Meanwhile, clinical studies and surveys have revealed that the major causes of death in patients undergoing long-term use of ventricular assist devices (VADs) were infection, thrombosis, and mechanical failure, all of which are typical of VADs. It is therefore of urgent and universal necessity to develop next-generation artificial hearts that have excellent durability to provide at least 2 years of event-free operation with a superior quality of life and that can be used for destination therapy to save patients with irreversible heart failure. It is also very important to ensure that an environment that facilitates the development, testing, and approval evaluation processes of next-generation artificial hearts be established as soon as possible.

Sinus MRI scan

MedlinePlus

... your body: Brain aneurysm clips Certain types of artificial heart valves Heart defibrillator or pacemaker Inner ear (cochlear) implants Recently placed artificial joints Certain types of vascular stents Pain pumps ...

Demikhov's "Mechanical Heart": The Circumstances Surrounding Creation of the World's First Implantable Total Artificial Heart in 1937.

PubMed

Glyantsev, Sergey P; Tchantchaleishvili, Vakhtang; Bockeria, Leo A

2016-01-01

The world's first implantable total artificial heart was designed by Vladimir Demikhov as a fourth year biology student in Voronezh, Soviet Union, in 1937. As a prototype of his device, Demikhov must have used an apparatus for extracorporeal blood circulation invented by Sergei Bryukhonenko of Moscow. The device was the size of a dog's native heart and consisted of two diaphragm pumps brought into motion by an electric motor. A dog with an implanted device lived for 2.5 hours. In addition to having the prototype, the preconditions for Demikhov's artificial heart creation were his manual dexterity, expertise in animal physiology, and his mechanistic worldview.

Total Artificial Heart Implantation After Undifferentiated High-Grade Sarcoma Excision

PubMed Central

Kremer, Jamila; Farag, Mina; Arif, Rawa; Brcic, Andreas; Sabashnikov, Anton; Schmack, Bastian; Popov, Aron-Frederik; Karck, Matthias; Dohmen, Pascal M.; Ruhparwar, Arjang; Weymann, Alexander

2016-01-01

Background Total artificial heart (TAH) implantation in patients with aggressive tumor infiltration of the heart can be challenging. Case Report We report on a patient with a rare primary undifferentiated high-grade spindle cell sarcoma of the mitral valve and in the left atrium, first diagnosed in 2014. The referring center did a first resection in 2014. In the course of 17 months, computer tomography (CT) scan again showed massive invasion of the mitral valve and left atrium. Partial resection and mitral valve replacement was not an option. We did a subtotal heart excision with total artificial heart implantation. In this report we discuss complications, risk factors, and perioperative management of this patient. Conclusions Patients with aggressive tumors of the heart can be considered for TAH implantation. PMID:27803495

Total Artificial Heart Implantation After Undifferentiated High-Grade Sarcoma Excision.

PubMed

Kremer, Jamila; Farag, Mina; Arif, Rawa; Brcic, Andreas; Sabashnikov, Anton; Schmack, Bastian; Popov, Aron-Frederik; Karck, Matthias; Dohmen, Pascal M; Ruhparwar, Arjang; Weymann, Alexander

2016-11-02

BACKGROUND Total artificial heart (TAH) implantation in patients with aggressive tumor infiltration of the heart can be challenging. CASE REPORT We report on a patient with a rare primary undifferentiated high-grade spindle cell sarcoma of the mitral valve and in the left atrium, first diagnosed in 2014. The referring center did a first resection in 2014. In the course of 17 months, computer tomography (CT) scan again showed massive invasion of the mitral valve and left atrium. Partial resection and mitral valve replacement was not an option. We did a subtotal heart excision with total artificial heart implantation. In this report we discuss complications, risk factors, and perioperative management of this patient. CONCLUSIONS Patients with aggressive tumors of the heart can be considered for TAH implantation.

The total artificial heart.

PubMed

Cook, Jason A; Shah, Keyur B; Quader, Mohammed A; Cooke, Richard H; Kasirajan, Vigneshwar; Rao, Kris K; Smallfield, Melissa C; Tchoukina, Inna; Tang, Daniel G

2015-12-01

The total artificial heart (TAH) is a form of mechanical circulatory support in which the patient's native ventricles and valves are explanted and replaced by a pneumatically powered artificial heart. Currently, the TAH is approved for use in end-stage biventricular heart failure as a bridge to heart transplantation. However, with an increasing global burden of cardiovascular disease and congestive heart failure, the number of patients with end-stage heart failure awaiting heart transplantation now far exceeds the number of available hearts. As a result, the use of mechanical circulatory support, including the TAH and left ventricular assist device (LVAD), is growing exponentially. The LVAD is already widely used as destination therapy, and destination therapy for the TAH is under investigation. While most patients requiring mechanical circulatory support are effectively treated with LVADs, there is a subset of patients with concurrent right ventricular failure or major structural barriers to LVAD placement in whom TAH may be more appropriate. The history, indications, surgical implantation, post device management, outcomes, complications, and future direction of the TAH are discussed in this review.

Anatomy of the bovine ascending aorta and brachiocephalic artery found unfavorable for total artificial heart implant.

PubMed

Karimov, Jamshid H; Sunagawa, Gengo; Such, Kimberly A; Sale, Shiva; Golding, Leonard A R; Moazami, Nader; Fukamachi, Kiyotaka

2015-12-01

The biocompatibility assessment of the Cleveland Clinic continuous-flow total artificial heart is an important part of the device developmental program. Surgical and postoperative management are key factors in achieving optimal outcomes. However, the presence of vascular anatomical abnormalities in experimental animal models is often unpredictable and may worsen the expected outcomes. We report a technical impediment encountered during total artificial heart implantation complicated by unfavorable bovine anatomy of the ascending aorta and brachiocephalic arterial trunk.

Post-explant visualization of thrombi in outflow grafts and their junction to a continuous-flow total artificial heart using a high-definition miniaturized camera.

PubMed

Karimov, Jamshid H; Horvath, David; Sunagawa, Gengo; Byram, Nicole; Moazami, Nader; Golding, Leonard A R; Fukamachi, Kiyotaka

2015-12-01

Post-explant evaluation of the continuous-flow total artificial heart in preclinical studies can be extremely challenging because of the device's unique architecture. Determining the exact location of tissue regeneration, neointima formation, and thrombus is particularly important. In this report, we describe our first successful experience with visualizing the Cleveland Clinic continuous-flow total artificial heart using a custom-made high-definition miniature camera.

Heart valve surgery - series (image)

MedlinePlus

... heart valves are either natural (biologic) or artificial (mechanical). Natural valves are from human donors (cadavers), modified ... artificial valves will require anticoagulation. The advantage of mechanical valves is that they last longer-thus, the ...

MRI

MedlinePlus

... the test, tell your provider if you have: Artificial heart valves Brain aneurysm clips Heart defibrillator or pacemaker Inner ear (cochlear) implants Kidney disease or dialysis (you may not ... artificial joints Vascular stents Worked with sheet metal in ...

Magnetic resonance angiography

MedlinePlus

... your provider if you have: Brain aneurysm clips Artificial heart valve Heart defibrillator or pacemaker Inner ear (cochlear) implants Insulin or chemotherapy port Intrauterine device (IUD) Kidney ... artificial joints Vascular stent Worked with sheet metal in ...

Successful heart transplant after 1374 days living with a total artificial heart.

PubMed

Gerosa, Gino; Gallo, Michele; Bottio, Tomaso; Tarzia, Vincenzo

2016-04-01

The CardioWest Total Artificial Heart (CW-TAH) has been approved as a temporary device for bridge to cardiac transplantation and is under investigation for destination therapy by US Food and Drug Administration (FDA). We herein report the longest worldwide survival out of hospital (1374 days) of a patient supported with Cardio West Total Artificial Heart (CW-TAH). This experience is intended as a proof of concept of using CW-TAH as the destination therapy in patients with biventricular failure. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Sleep and wake phase of heart beat dynamics by artificial insymmetrised patterns

NASA Astrophysics Data System (ADS)

Dudkowska, A.; Makowiec, D.

2004-05-01

In order to determine differences between healthy patients and patients with congestive heart failure we apply the artificial insymmetrised pattern (AIP) method. The AIP method by exploring a human eye ability to extract regularities and read symmetries in a dot pattern, serves a tool for qualitative discrimination of heart rate states.

Design of a hydraulic analog of the circulatory system for evaluating artificial hearts.

PubMed

Donovan, F M

1975-01-01

A major problem in improving artificial heart designs is the absence of methods for accurate in vitro testing of artificial heart systems. A mock circulatory system has been constructed which hydraulically simulates the systemic and pulmonary circulations of the normal human. The device is constructed of 1/2 in. acrylic sheet and has overall dimensions of 24 in. wide, 16 in. tall, and 8 in. deep. The artificial heart to be tested is attached to the front of the device, and pumps fluid from the systemic venous chamber into the pulmonary arterial chamber and from the pulmonary venous chamber into the systemic arterial chamber. Each of the four chambers is hermetically sealed. The compliance of each chamber is determined by the volume of air trapped above the fluid in that chamber. The pulmonary and systemic resistances are set automatically by bellows-operated valves to simulate the barroreceptor response in the systemic arteries and the passive pulmonary resistance response in the pulmonary arteries. Cardiac output is measured by a turbine flowmeter in the systemic circulation. Results using the Kwan-Gett artificial heart show a good comparison between the mock circulatory system response and the calf response.

Functionality of albumin-derived perfluorocarbon-based artificial oxygen carriers in the Langendorff-heart †.

PubMed

Wrobeln, Anna; Schlüter, Klaus D; Linders, Jürgen; Zähres, Manfred; Mayer, Christian; Kirsch, Michael; Ferenz, Katja B

2017-06-01

The aim of this study was to prove whether albumin-derived perfluorocarbon-based nanoparticles (capsules) can operate as a novel artificial oxygen carrier in a rat Langendorff-heart perfusion model. Hearts perfused with capsules showed increased left ventricular pressure and rate pressure product compared to hearts perfused with pure Krebs-Henseleit (KH)-buffer. The capsules prevented the myocardium from functional fail when in their absence a noxious ischemia was observed. Capsules did not change rheological properties of KH-buffer and could repeatedly reload with oxygen. This albumin-derived perfluorocarbon-based artificial oxygen carrier preserved the function of rat hearts due to the transport of oxygen in a satisfactory manner. Because of these positive results, the functionality of the applied capsules should be verified in living animals.

The total artificial heart

PubMed Central

Cook, Jason A.; Shah, Keyur B.; Quader, Mohammed A.; Cooke, Richard H.; Kasirajan, Vigneshwar; Rao, Kris K.; Smallfield, Melissa C.; Tchoukina, Inna

2015-01-01

The total artificial heart (TAH) is a form of mechanical circulatory support in which the patient’s native ventricles and valves are explanted and replaced by a pneumatically powered artificial heart. Currently, the TAH is approved for use in end-stage biventricular heart failure as a bridge to heart transplantation. However, with an increasing global burden of cardiovascular disease and congestive heart failure, the number of patients with end-stage heart failure awaiting heart transplantation now far exceeds the number of available hearts. As a result, the use of mechanical circulatory support, including the TAH and left ventricular assist device (LVAD), is growing exponentially. The LVAD is already widely used as destination therapy, and destination therapy for the TAH is under investigation. While most patients requiring mechanical circulatory support are effectively treated with LVADs, there is a subset of patients with concurrent right ventricular failure or major structural barriers to LVAD placement in whom TAH may be more appropriate. The history, indications, surgical implantation, post device management, outcomes, complications, and future direction of the TAH are discussed in this review. PMID:26793338

Cervical MRI scan

MedlinePlus

... you have: Brain aneurysm clips Certain types of artificial heart valves Heart defibrillator or pacemaker Inner ear (cochlear) implants Kidney disease or dialysis (you may not be able to receive contrast) Recently placed artificial joints Certain types of vascular stents Worked with ...

Lumbar MRI scan

MedlinePlus

... you have: Brain aneurysm clips Certain types of artificial heart valves Heart defibrillator or pacemaker Inner ear (cochlear) implants Kidney disease or dialysis (you may not be able to receive contrast) Recently placed artificial joints Certain types of vascular stents Worked with ...

Shoulder MRI scan

MedlinePlus

... you have: Brain aneurysm clips Certain types of artificial heart valves Heart defibrillator or pacemaker Inner ear (cochlear) implants Kidney disease or dialysis (you may not be able to receive contrast) Recently placed artificial joints Certain types of vascular stents Worked with ...

Percutaneous dilatational tracheostomy following total artificial heart implantation.

PubMed

Spiliopoulos, Sotirios; Dimitriou, Alexandros Merkourios; Serrano, Maria Rosario; Guersoy, Dilek; Autschbach, Ruediger; Goetzenich, Andreas; Koerfer, Reiner; Tenderich, Gero

2015-07-01

Coagulation disorders and an immune-altered state are common among total artificial heart patients. In this context, we sought to evaluate the safety of percutaneous dilatational tracheostomy in cases of prolonged need for mechanical ventilatory support. We retrospectively analysed the charts of 11 total artificial heart patients who received percutaneous dilatational tracheostomy. We focused on early and late complications. We observed no major complications and no procedure-related deaths. Early minor complications included venous oozing (45.4%) and one case of local infection. Late complications, including subglottic stenosis, stomal infection or infections of the lower respiratory tract, were not observed. In conclusion, percutaneous dilatational tracheostomy in total artificial heart patients is safe. Considering the well-known benefits of early tracheotomy over prolonged translaryngeal intubation, we advocate early timing of therapy in cases of prolonged mechanical ventilation. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Total artificial heart implantation for biventricular failure due to eosinophilic myocarditis.

PubMed

Kawabori, Masashi; Kurihara, Chitaru; Miller, Yair; Heck, Kent A; Bogaev, Roberta C; Civitello, Andrew B; Cohn, William E; Frazier, O H; Morgan, Jeffrey A

2017-09-01

Idiopathic hypereosinophilic syndrome is a condition of unknown etiology characterized by proliferation of eosinophils and their infiltration into tissues. Although cardiac involvement is rare, eosinophilic myocarditis can lead to life-threating fulminant congestive heart failure. Treatment of patients with eosinophilic myocarditis is challenging as heart failure can be caused by biventricular dysfunction. To our knowledge, this is the first case reported in the literature describing a patient with acute severe biventricular heart failure caused by eosinophilic myocarditis with mural left ventricular apical thrombus who was successfully treated with implantation of a total artificial heart as a bridge to heart transplant.

Testing of Safety-Critical Software Embedded in an Artificial Heart

NASA Astrophysics Data System (ADS)

Cha, Sungdeok; Jeong, Sehun; Yoo, Junbeom; Kim, Young-Gab

Software is being used more frequently to control medical devices such as artificial heart or robotic surgery system. While much of software safety issues in such systems are similar to other safety-critical systems (e.g., nuclear power plants), domain-specific properties may warrant development of customized techniques to demonstrate fitness of the system on patients. In this paper, we report results of a preliminary analysis done on software controlling a Hybrid Ventricular Assist Device (H-VAD) developed by Korea Artificial Organ Centre (KAOC). It is a state-of-the-art artificial heart which completed animal testing phase. We performed software testing in in-vitro experiments and animal experiments. An abnormal behaviour, never detected during extensive in-vitro analysis and animal testing, was found.

A first step beyond traditional boundaries: destination therapy with the SynCardia total artificial heart.

PubMed

Spiliopoulos, Sotirios; Koerfer, Reiner; Tenderich, Gero

2014-06-01

The SynCardia total artificial heart is currently used as a bridge to transplantation therapy in cases of irreversible, acute or chronic, biventricular heart failure. We describe the implementation of this technology in the context of destination therapy in a patient with an end-stage heart failure on grounds of primary amyloidosis. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Establishing the framework to support bioartificial heart fabrication using fibrin-based three-dimensional artificial heart muscle.

PubMed

Hogan, Matthew; Mohamed, Mohamed; Tao, Ze-Wei; Gutierrez, Laura; Birla, Ravi

2015-02-01

Only 3000 heart transplants are performed in the USA every year, leaving some 30 000-70 000 Americans without proper care. Current treatment modalities for heart failure have saved many lives yet still do not correct the underlying problems of congestive heart failure. Tissue engineering represents a potential field of study wherein a combination of cells, scaffolds, and/or bioreactors can be utilized to create constructs to mimic, replace, and/or repair defective tissue. The focus of this study was to generate a bioartificial heart (BAH) model using artificial heart muscle (AHM), composed of fibrin gel and neonatal rat cardiac myocytes, and a decellularized scaffold, formed by subjecting an adult rat heart to a series of decellularization solutions. By suturing the AHM around the outside of the decellularized heart and culturing while suspended in media, we were able to retain functional cardiac cells on the scaffold as evinced by visible contractility. Observed contractility rate was correlated with biopotential measurements to confirm essential functionality of cardiac constructs. Cross-sections of the BAH show successful decellularization of the scaffold and contiguous cell-rich AHM around the perimeter of the heart. Copyright © 2014 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Combined heart-kidney transplantation after total artificial heart insertion.

PubMed

Ruzza, A; Czer, L S C; Ihnken, K A; Sasevich, M; Trento, A; Ramzy, D; Esmailian, F; Moriguchi, J; Kobashigawa, J; Arabia, F

2015-01-01

We present the first single-center report of 2 consecutive cases of combined heart and kidney transplantation after insertion of a total artificial heart (TAH). Both patients had advanced heart failure and developed dialysis-dependent renal failure after implantation of the TAH. The 2 patients underwent successful heart and kidney transplantation, with restoration of normal heart and kidney function. On the basis of this limited experience, we consider TAH a safe and feasible option for bridging carefully selected patients with heart and kidney failure to combined heart and kidney transplantation. Recent FDA approval of the Freedom driver may allow outpatient management at substantial cost savings. The TAH, by virtue of its capability of providing pulsatile flow at 6 to 10 L/min, may be the mechanical circulatory support device most likely to recover patients with marginal renal function and advanced heart failure. Copyright © 2015 Elsevier Inc. All rights reserved.

Heart Conditions and Pregnancy: Know the Risks

MedlinePlus

... threatening infection of the lining of the heart (endocarditis) and heart valves. Mechanical artificial heart valves also ... your baby. If you're at risk of endocarditis, you might receive antibiotic treatment just before and ...

Thrombotic Depositions on Right Impeller of Double-Ended Centrifugal Total Artificial Heart In Vivo.

PubMed

Karimov, Jamshid H; Horvath, David J; Okano, Shinji; Goodin, Mark; Sunagawa, Gengo; Byram, Nicole; Moazami, Nader; Golding, Leonard A R; Fukamachi, Kiyotaka

2017-05-01

The development of total artificial heart devices is a complex undertaking that includes chronic biocompatibility assessment of the device. It is considered particularly important to assess whether device design and features can be compatible long term in a biological environment. As part of the development program for the Cleveland Clinic continuous-flow total artificial heart (CFTAH), we evaluated the device for signs of thrombosis and biological material deposition in four animals that had achieved the intended 14-, 30-, or 90-day durations in each respective experiment. Explanted CFTAHs were analyzed for possible clot buildup at "susceptible" areas inside the pump, particularly the right pump impeller. Depositions of various consistency and shapes were observed. We here report our findings, along with macroscopic and microscopic analysis post explant, and provide computational fluid dynamics data with its potential implications for thrombus formation. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Past and Present of Total Artificial Heart Therapy: A Success Story.

PubMed

Samak, Mostafa; Fatullayev, Javid; Sabashnikov, Anton; Zeriouh, Mohamed; Rahmanian, Parwis B; Choi, Yeong-Hoon; Wippermann, Jens; Wahlers, Thorsten; Schmack, Bastian; Ruhparwar, Arjang; Dohmen, Pascal M; Karck, Matthias; Popov, Aron-Frederik; Simon, André R; Weymann, Alexander

2015-09-07

The totally artificial heart (TAH) is among the most prominent medical innovations of the 21st century, especially due to the increasing population with end-stage heart failure. The progressive course of the disease, its resistance to conventional therapy, and the scarcity of hearts available for transplantation were the prime impetus for developing a TAH, especially when other options of mechanical circulatory assist devices are exhausted. In this review, we narrate the history of TAH, give an overview of its technology, and address the pros and cons of the currently available TAH models in light of published clinical experience.

If Your Child Has a Heart Defect (For Parents)

MedlinePlus

... congenital heart disease are at risk for bacterial endocarditis, an infection of the tissue that lines the ... who have artificial heart valves or have had endocarditis before. Most children with heart problems, however, do ...

Artificial heart and assist devices: directions, needs, costs, societal and ethical issues.

PubMed

Van Citters, R L; Bauer, C B; Christopherson, L K; Eberhart, R C; Eddy, D M; Frye, R L; Jonsen, A R; Keller, K H; Levine, R J; McGoon, D C

1985-11-01

A Working Group appointed by the Director of the National Heart, Lung, and Blood Institute (NHBLI) has reviewed the current status of mechanical circulatory support systems (MCSS), and has examined the potential need for such devices, their cost, and certain societal and ethical issues related to their use. The media have reported the limited clinical investigative use of pneumatically energized total artificial hearts (which actually replace the patient's heart) and left ventricular assist devices (which support or replace the function of the left ventricle by pumping blood from the left heart to the aorta with the patient's heart in place). However, electrically energized systems, which will allow full implantation, permit relatively normal everyday activity, and involve battery exchange or recharge two or three times a day, are currently approaching long-term validation in animals prior to clinical testing. Such long-term left ventricular assist devices have been the primary goal of the NHLBI targeted artificial heart program. Although the ventricular assist device is regarded as an important step in the sequence of MCSS development, the Working Group believes that a fully implantable, long-term, total artificial heart will be a clinical necessity and recommends that the mission of the targeted program include the development of such systems. Past estimates of the potential usage of artificial hearts have been reviewed in the context of advances in medical care and in the prevention of cardiovascular disease. In addition, a retrospective analysis of needs was carried out within a defined population. The resulting projection of 17,000-35,000 cases annually, in patients below age 70, falls within the general range of earlier estimates, but is highly sensitive to many variables. In the absence of an actual base of data and experience with MCSS, projection of costs and prognoses was carried out using explicit sets of assumptions. The total cost of a left ventricular assist device, its implantation and maintenance for a projected average of 4 1/2 years of survival might be approximately $150,000 (in 1983 dollars). The gross annual cost to society could fall in the range of $2.5-$5 billion. Ethical issues associated with use of the artificial heart are not unique. For individual patients these relate primarily to risk-benefit, informed consent, patient selection, and privacy. However, for society as a whole, the larger concern relates to the distribution of national resources.(ABSTRACT TRUNCATED AT 400 WORDS)

Novel technique for airless connection of artificial heart to vascular conduits.

PubMed

Karimov, Jamshid H; Gao, Shengqiang; Dessoffy, Raymond; Sunagawa, Gengo; Sinkewich, Martin; Grady, Patrick; Sale, Shiva; Moazami, Nader; Fukamachi, Kiyotaka

2017-12-01

Successful implantation of a total artificial heart relies on multiple standardized procedures, primarily the resection of the native heart, and exacting preparation of the atrial and vascular conduits for pump implant and activation. Achieving secure pump connections to inflow/outflow conduits is critical to a successful outcome. During the connection process, however, air may be introduced into the circulation, traveling to the brain and multiple organs. Such air emboli block blood flow to these areas and are detrimental to long-term survival. A correctly managed pump-to-conduit connection prevents air from collecting in the pump and conduits. To further optimize pump-connection techniques, we have developed a novel connecting sleeve that enables airless connection of the Cleveland Clinic continuous-flow total artificial heart (CFTAH) to the conduits. In this brief report, we describe the connecting sleeve design and our initial results from two acute in vivo implantations using a scaled-down version of the CFTAH.

Application of Artificial Neural Networks in the Heart Electrical Axis Position Conclusion Modeling

NASA Astrophysics Data System (ADS)

Bakanovskaya, L. N.

2016-08-01

The article touches upon building of a heart electrical axis position conclusion model using an artificial neural network. The input signals of the neural network are the values of deflections Q, R and S; and the output signal is the value of the heart electrical axis position. Training of the network is carried out by the error propagation method. The test results allow concluding that the created neural network makes a conclusion with a high degree of accuracy.

Total Artificial Heart Implantation after Excision of Right Ventricular Angiosarcoma.

PubMed

Bruckner, Brian A; Abu Saleh, Walid K; Al Jabbari, Odeaa; Copeland, Jack G; Estep, Jerry D; Loebe, Matthias; Reardon, Michael J

2016-06-01

Primary cardiac sarcomas, although rare, are aggressive and lethal, requiring thorough surgical resection and adjuvant chemotherapy for the best possible outcome. We report the case of a 32-year-old woman who underwent total artificial heart implantation for right-sided heart failure caused by right ventricular angiosarcoma. For the first several weeks in intensive care, the patient recovered uneventfully. However, a postoperative liver biopsy indicated hepatocellular injury consistent with preoperative chemotherapy. She developed continuing liver failure, from which she died despite good cardiac function.

Total Artificial Heart Bridge to Transplantation for a Patient With Occult Intracardiac Malignancy: Case Report.

PubMed

Reich, H; Czer, L; Bannykh, S; De Robertis, M; Wolin, E; Amersi, F; Moriguchi, J; Kobashigawa, J; Arabia, F

2015-09-01

Malignancy is the leading cause of long-term morbidity and mortality after heart and other solid organ transplantation; therefore, great emphasis is placed on pre- and post-transplantation cancer screening. Even with meticulous screening during evaluation for heart transplant candidacy, an occult cancer may not be apparent. Here, we share the case of a 51-year-old man with refractory heart failure who underwent total artificial heart implantation as a bridge to transplantation with the surprise finding of an isolated deposit of metastatic carcinoid tumor nested within a left ventricular papillary muscle in his explanted heart. The primary ileal carcinoid tumor was identified and resected completely. After remaining cancer-free for 14 months, he was listed for heart transplantation and was transplanted 2 months later. He is currently 3.5 months out from heart transplantation and doing well, without evidence of recurring malignancy. Copyright © 2015 Elsevier Inc. All rights reserved.

Willem J Kolff (1911-2009): physician, inventor and pioneer: father of artificial organs.

PubMed

Morrissey, Megan

2012-08-01

Medical pioneer Willem Johan Kolff was an inspirational father, son, physician and inventor. He founded the development of the first kidney dialysis machine, pioneered advances in the heart and lung machine, laid down the foundations for the first mainland blood bank in Europe and successfully implanted the first artificial heart into humans.

Elective Inactivation of Total Artificial Heart Technology in Non-Futile Situations: Inpatients, Outpatients and Research Participants

ERIC Educational Resources Information Center

Bramstedt, Katrina A.

2004-01-01

Total artificial heart technology as a potential clinical therapy raises the issue of elective device inactivation in both futile and non-futile situations. This article explores elective device inactivation in non-futile situations. In reply to such requests for inactivation, the medical team should reflect on the individual's decision-making…

First North American 50 cc Total Artificial Heart Experience: Conversion from a 70 cc Total Artificial Heart.

PubMed

Khalpey, Zain; Kazui, Toshinobu; Ferng, Alice S; Connell, Alana; Tran, Phat L; Meyer, Mark; Rawashdeh, Badi; Smith, Richard G; Sweitzer, Nancy K; Friedman, Mark; Lick, Scott; Slepian, Marvin J; Copeland, Jack G

2016-01-01

The 70 cc total artificial heart (TAH) has been utilized as bridge to transplant (BTT) for biventricular failure. However, the utilization of 70 cc TAH has been limited to large patients for the low output from the pulmonary as well as systemic vein compression after chest closure. Therefore, the 50 cc TAH was developed by SynCardia (Tucson, AZ) to accommodate smaller chest cavity. We report the first TAH exchange from a 70 to 50 cc due to a fit difficulty. The patient failed to be closed with a 70 cc TAH, although the patient met the conventional 70 cc TAH fit criteria. We successfully closed the chest with a 50 cc TAH.

An original valveless artificial heart providing pulsatile flow tested in mock circulatory loops.

PubMed

Tozzi, Piergiorgio; Maertens, Audrey; Emery, Jonathan; Joseph, Samuel; Kirsch, Matthias; Avellan, François

2017-11-24

We present the test bench results of a valveless total artificial heart that is potentially compatible with the pediatric population. The RollingHeart is a valveless volumetric pump generating pulsatile flow. It consists of a single spherical cavity divided into 4 chambers by 2 rotating disks. The combined rotations of both disks produce changes in the volumes of the 4 cavities (suction and ejection). The blood enters/exits the spherical cavity through 4 openings that are symmetrical to the fixed rotation axis of the first disk.Mock circulatory system: The device pumps a 37% glycerin solution through 2 parallel circuits, simulating the pulmonary and systemic circulations. Flow rates are acquired with a magnetic inductive flowmeter, while pressure sensors collect pressure in the left and right outflow and inflow tracts.In vitro test protocol: The pump is run at speeds ranging from 20 to 180 ejections per minute. The waveform of the pressure generated at the inflow and outflow of the 4 chambers and the flow rate in the systemic circulation are measured. At an ejection rate of 178 min-1, the RollingHeart pumps 5.3 L/min for a systemic maximal pressure gradient of 174 mmHg and a pulmonary maximal pressure gradient of 75 mmHg. The power input was 14 W, corresponding to an efficiency of 21%. The RollingHeart represents a new approach in the domain of total artificial heart. This preliminary study endorses the feasibility of a single valveless device acting as a total artificial heart.

Machines versus medication for biventricular heart failure: focus on the total artificial heart.

PubMed

Arabia, Francisco A; Moriguchi, Jaime D

2014-09-01

The medical/surgical management of advanced heart failure has evolved rapidly over the last few decades. With better understanding of heart failure pathophysiology, new pharmacological agents have been introduced that have resulted in improvements in survival. For those patients that fail to improve, mechanical circulatory support with left ventricular assist devices and total artificial hearts (TAHs) have served as a beneficial bridge to transplantation. The TAH has continued to play a significant role as a bridge to transplantation in patients with biventricular failure and more selected indications that could not be completely helped with left ventricular assist devices. Improved survival with the TAH has resulted in more patients benefiting from this technology. Improvements will eventually lead to a totally implantable device that will permanently replace the failing human heart.

System overview of the fully implantable destination therapy--ReinHeart-total artificial heart.

PubMed

Pelletier, Benedikt; Spiliopoulos, Sotirios; Finocchiaro, Thomas; Graef, Felix; Kuipers, Kristin; Laumen, Marco; Guersoy, Dilek; Steinseifer, Ulrich; Koerfer, Reiner; Tenderich, Gero

2015-01-01

Owing to the lack of suitable allografts, the demand for long-term mechanical circulatory support in patients with biventricular end-stage heart failure is rising. Currently available Total Artificial Heart (TAH) systems consist of pump units with only limited durability, percutaneous tubes and bulky external equipment that limit the quality of life. Therefore we are focusing on the development of a fully implantable, highly durable destination therapy total artificial heart. The ReinHeart-TAH system consists of a passively filling pump unit driven by a low-wear linear drive between two artificial ventricles, an implantable control unit and a compliance chamber. The TAH is powered by a transcutaneous energy transmission system. The flow distribution inside the ventricles was analysed by fluid structure interaction simulation and particle image velocimetry measurements. Along with durability tests, the hydrodynamic performance and flow balance capability were evaluated in a mock circulation loop. Animal trials are ongoing. Based on fluid structure interaction simulation and particle image velocimetry, blood stagnation areas have been significantly reduced. In the mock circulation loop the ReinHeart-TAH generated a cardiac output of 5 l/min at an operating frequency of 120 bpm and an aortic pressure of 120/80 mmHg. The highly effective preload sensitivity of the passively filling ventricles allowed the sensorless integration of the Frank Starling mechanism. The ReinHeart-TAH effectively replaced the native heart's function in animals for up to 2 days. In vitro and in vivo testing showed a safe and effective function of the ReinHeart-TAH system. This has the potential to become an alternative to transplantation. However, before a first-in-man implant, chronic animal trials still have to be completed. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Past and Present of Total Artificial Heart Therapy: A Success Story

PubMed Central

Samak, Mostafa; Fatullayev, Javid; Sabashnikov, Anton; Zeriouh, Mohamed; Rahmanian, Parwis B.; Choi, Yeong-Hoon; Wippermann, Jens; Wahlers, Thorsten; Schmack, Bastian; Ruhparwar, Arjang; Dohmen, Pascal M.; Karck, Matthias; Popov, Aron-Frederik; Simon, André R.; Weymann, Alexander

2015-01-01

The totally artificial heart (TAH) is among the most prominent medical innovations of the 21st century, especially due to the increasing population with end-stage heart failure. The progressive course of the disease, its resistance to conventional therapy, and the scarcity of hearts available for transplantation were the prime impetus for developing a TAH, especially when other options of mechanical circulatory assist devices are exhausted. In this review, we narrate the history of TAH, give an overview of its technology, and address the pros and cons of the currently available TAH models in light of published clinical experience. PMID:26343363

Physiological Characterization of the SynCardia Total Artificial Heart in a Mock Circulation System

PubMed Central

Crosby, Jessica R.; DeCook, Katrina J.; Tran, Phat L.; Smith, Richard G.; Larson, Douglas F.; Khalpey, Zain I.; Burkhoff, Daniel; Slepian, Marvin J.

2014-01-01

The SynCardia total artificial heart (TAH) has emerged as an effective, life-saving bi-ventricular replacement system for a wide variety of patients with end-stage heart failure. While the clinical performance of the TAH is established, modern physiologic characterization, in terms of elastance behavior and pressure-volume characterization has not been defined. Herein we examine the TAH in terms of elastance using a non-ejecting left-ventricle, and then characterize the pressure-volume relationship of the TAH by varying preload and afterload parameters using a Donovan Mock Circulatory System. We demonstrate that the TAH does not operate with time-varying elastance, differing from the human heart. Further, we show that the TAH has a pressure-volume relationship behavior that also differs from that of the human heart. The TAH does exhibit Starling-like behavior, with output increasing via preload dependent mechanisms, without reliance on an alteration of inotropic state within the operating window of the TAH. Within our testing range, the TAH is insensitive to variations in afterload, however this insensitivity has a limit, the limit being the maximum driving pressure of the pneumatic driver. Understanding the physiology of the TAH affords insight into the functional parameters that govern artificial heart behavior providing perspective on differences compared to the human heart. PMID:25551416

Physiological characterization of the SynCardia total artificial heart in a mock circulation system.

PubMed

Crosby, Jessica R; DeCook, Katrina J; Tran, Phat L; Smith, Richard G; Larson, Douglas F; Khalpey, Zain I; Burkhoff, Daniel; Slepian, Marvin J

2015-01-01

The SynCardia total artificial heart (TAH) has emerged as an effective, life-saving biventricular replacement system for a wide variety of patients with end-stage heart failure. Although the clinical performance of the TAH is established, modern physiological characterization, in terms of elastance behavior and pressure-volume (PV) characterization has not been defined. Herein, we examine the TAH in terms of elastance using a nonejecting left ventricle, and then characterize the PV relation of the TAH by varying preload and afterload parameters using a Donovan Mock Circulatory System. We demonstrate that the TAH does not operate with time-varying elastance, differing from the human heart. Furthermore, we show that the TAH has a PV relation behavior that also differs from that of the human heart. The TAH does exhibit Starling-like behavior, with output increasing via preload-dependent mechanisms, without reliance on an alteration of inotropic state within the operating window of the TAH. Within our testing range, the TAH is insensitive to variations in afterload; however, this insensitivity has a limit, the limit being the maximum driving pressure of the pneumatic driver. Understanding the physiology of the TAH affords insight into the functional parameters that govern artificial heart behavior providing perspective on differences compared with the human heart.

Getting a New Heart

MedlinePlus

... may be able to replace it with an artificial (man-made) valve. Cardiac size reduction . During this procedure, your doctor removes a piece of the heart muscle from an enlarged heart. This makes your ...

[Artificial organs].

PubMed

Raguin, Thibaut; Dupret-Bories, Agnès; Debry, Christian

2017-01-01

Research has been fighting against organ failure and shortage of donations by supplying artificial organs for many years. With the raise of new technologies, tissue engineering and regenerative medicine, many organs can benefit of an artificial equivalent: thanks to retinal implants some blind people can visualize stimuli, an artificial heart can be proposed in case of cardiac failure while awaiting for a heart transplant, artificial larynx enables laryngectomy patients to an almost normal life, while the diabetic can get a glycemic self-regulation controlled by smartphones with an artificial device. Dialysis devices become portable, as well as the oxygenation systems for terminal respiratory failure. Bright prospects are being explored or might emerge in a near future. However, the retrospective assessment of putative side effects is not yet sufficient. Finally, the cost of these new devices is significant even if the advent of three dimensional printers may reduce it. © 2017 médecine/sciences – Inserm.

Improvement in magnetic field immunity of externally-coupled transcutaneous energy transmission system for a totally implantable artificial heart.

PubMed

Yamamoto, Takahiko; Koshiji, Kohji; Homma, Akihiko; Tatsumi, Eisuke; Taenaka, Yoshiyuki

2008-01-01

Transcutaneous energy transmission (TET) that uses electromagnetic induction between the external and internal coils of a transformer is the most promising method to supply driving energy to a totally implantable artificial heart without invasion. Induction-heating (IH) cookers generate magnetic flux, and if a cooker is operated near a transcutaneous transformer, the magnetic flux generated will link with the external and internal coils of the transcutaneous transformer. This will affect the performance of the TET and the artificial heart system. Hence, it is necessary to improve the magnetic field immunity of the TET system. During operation of the system, if the transcutaneous transformer is in close proximity to an IH cooker, the electric power generated by the cooker and coupled to the transformer can drive the artificial heart system. To prevent this coupling, the external coil was shielded with a conductive shield that had a slit in it. This reduces the coupling between the transformer and the magnetic field generated by the induction cooker. However, the temperature of the shield increased due to heating by eddy currents. The temperature of the shield can be reduced by separating the IH cooker and the shield.

Numerical Simulation of Flow Through an Artificial Heart

NASA Technical Reports Server (NTRS)

Rogers, Stuart E.; Kutler, Paul; Kwak, Dochan; Kiris, Cetin

1989-01-01

A solution procedure was developed that solves the unsteady, incompressible Navier-Stokes equations, and was used to numerically simulate viscous incompressible flow through a model of the Pennsylvania State artificial heart. The solution algorithm is based on the artificial compressibility method, and uses flux-difference splitting to upwind the convective terms; a line-relaxation scheme is used to solve the equations. The time-accuracy of the method is obtained by iteratively solving the equations at each physical time step. The artificial heart geometry involves a piston-type action with a moving solid wall. A single H-grid is fit inside the heart chamber. The grid is continuously compressed and expanded with a constant number of grid points to accommodate the moving piston. The computational domain ends at the valve openings where nonreflective boundary conditions based on the method of characteristics are applied. Although a number of simplifing assumptions were made regarding the geometry, the computational results agreed reasonably well with an experimental picture. The computer time requirements for this flow simulation, however, are quite extensive. Computational study of this type of geometry would benefit greatly from improvements in computer hardware speed and algorithm efficiency enhancements.

Heart murmur detection based on wavelet transformation and a synergy between artificial neural network and modified neighbor annealing methods.

PubMed

Eslamizadeh, Gholamhossein; Barati, Ramin

2017-05-01

Early recognition of heart disease plays a vital role in saving lives. Heart murmurs are one of the common heart problems. In this study, Artificial Neural Network (ANN) is trained with Modified Neighbor Annealing (MNA) to classify heart cycles into normal and murmur classes. Heart cycles are separated from heart sounds using wavelet transformer. The network inputs are features extracted from individual heart cycles, and two classification outputs. Classification accuracy of the proposed model is compared with five multilayer perceptron trained with Levenberg-Marquardt, Extreme-learning-machine, back-propagation, simulated-annealing, and neighbor-annealing algorithms. It is also compared with a Self-Organizing Map (SOM) ANN. The proposed model is trained and tested using real heart sounds available in the Pascal database to show the applicability of the proposed scheme. Also, a device to record real heart sounds has been developed and used for comparison purposes too. Based on the results of this study, MNA can be used to produce considerable results as a heart cycle classifier. Copyright © 2017 Elsevier B.V. All rights reserved.

[Heart transplantation and long-term lvad support cost-effectiveness model].

PubMed

Szentmihályi, Ilona; Barabás, János Imre; Bali, Ágnes; Kapus, Gábor; Tamás, Csilla; Sax, Balázs; Németh, Endre; Pólos, Miklós; Daróczi, László; Kőszegi, Andrea; Cao, Chun; Benke, Kálmán; Kovács, Péter Barnabás; Fazekas, Levente; Szabolcs, Zoltán; Merkely, Béla; Hartyánszky, István

2016-12-01

Heart transplantation is a high priority project at Semmelweis University. In accordance with this, the funding of heart transplantation and mechanical circulatory support also constitutes an important issue. In this report, the authors discuss the creation of a framework with the purpose of comparing the cost-effectiveness of heart transplantation and artificial heart implantation. Our created framework includes the calculation of cost, using the direct allocation method, calculating the incremental cost-effectiveness ratio and creating a cost-effectiveness plane. Using our model, it is possible to compare the initial, perioperative and postoperative expenses of both the transplanted and the artificial heart groups. Our framework can possibly be used for the purposes of long term follow-up and with the inclusion of a sufficient number of patients, the creation of cost-effectiveness analyses and supporting strategic decision-making.

Artificial heart pumps: bridging the gap between science, technology and personalized medicine by relational medicine.

PubMed

Raia, Federica; Deng, Mario C

2017-01-01

In the US population of 300 million, 3 million have heart failure with reduced ejection fraction and 300,000 have advanced heart failure. Long-term mechanical circulatory support will, within the next decade, be recommended to 30,000 patients annually in the USA, 3000 undergo heart transplantation annually. What do these advances mean for persons suffering from advanced heart failure and their loved ones/caregivers? In this perspective article, we discuss - by exemplifying a case report of a 27-year-old man receiving a Total Artificial Heart - a practice concept of modern medicine that fully incorporates the patient's personhood perspective which we have termed Relational Medicine™. From this case study, it becomes apparent that the successful practice of modern cardiovascular medicine requires the person-person encounter as a core practice element.

Working Model Hearts

ERIC Educational Resources Information Center

Brock, David

2009-01-01

Despite student interest, the heart is often a poorly understood topic in biology. To help students understand this vital organ's physiology, the author created this investigation activity involving the mammalian heart and its role in the circulatory system. Students design, build, and demonstrate working artificial "hearts" to exhibit what they…

An electric artificial heart for clinical use.

PubMed Central

Pierce, W S; Rosenberg, G; Snyder, A J; Pae, W E; Donachy, J H; Waldhausen, J A

1990-01-01

Advances in microelectronics, high-strength magnets, and control system design now make replacement of the heart using an implantable, electrically powered pump feasible. The device described herein is a compact, dual pusher plate unit with valved polyurethane sac-type ventricles positioned at either end. The power unit consists of a small, brushless direct current motor and a motion translator. A microprocessor control system is used to regulate heart beat rate and provide left-right output balance. Bench studies lasting for as long as 1 year have been performed. Heart replacement with the electric heart has been performed in 18 calves since 1984. The longest survivor lived for more than 7 months. Among the causes of termination were component failure, thromboembolic complications, and bleeding. No major problem has been identified that precludes prolonged use of the electric heart. In the future the patient with end-stage heart disease will have an electric artificial heart as one therapeutic option. Images Figs. 1A and 1B. Fig. 3. Fig. 5. PMID:2396885

Veno-venous extracorporeal membrane oxygenation using an innovative dual-lumen cannula following implantation of a total artificial heart.

PubMed

Youdle, Jemma; Penn, Sarah; Maunz, Olaf; Simon, Andre

2017-01-01

We report our first clinical use of the new Protek Duo TM cannula for peripheral veno-venous extra-corporeal life support (ECLS). A 53-year-old male patient underwent implantation of a total artificial heart (TAH) for biventricular failure. However, due to the development of post-operative respiratory dysfunction, the patient required ECLS for six days.

A Soft Total Artificial Heart-First Concept Evaluation on a Hybrid Mock Circulation.

PubMed

Cohrs, Nicholas H; Petrou, Anastasios; Loepfe, Michael; Yliruka, Maria; Schumacher, Christoph M; Kohll, A Xavier; Starck, Christoph T; Schmid Daners, Marianne; Meboldt, Mirko; Falk, Volkmar; Stark, Wendelin J

2017-10-01

The technology of 3D-printing has allowed the production of entirely soft pumps with complex chamber geometries. We used this technique to develop a completely soft pneumatically driven total artificial heart from silicone elastomers and evaluated its performance on a hybrid mock circulation. The goal of this study is to present an innovative concept of a soft total artificial heart (sTAH). Using the form of a human heart, we designed a sTAH, which consists of only two ventricles and produced it using a 3D-printing, lost-wax casting technique. The diastolic properties of the sTAH were defined and the performance of the sTAH was evaluated on a hybrid mock circulation under various physiological conditions. The sTAH achieved a blood flow of 2.2 L/min against a systemic vascular resistance of 1.11 mm Hg s/mL (afterload), when operated at 80 bpm. At the same time, the mean pulmonary venous pressure (preload) was fixed at 10 mm Hg. Furthermore, an aortic pulse pressure of 35 mm Hg was measured, with a mean aortic pressure of 48 mm Hg. The sTAH generated physiologically shaped signals of blood flow and pressures by mimicking the movement of a real heart. The preliminary results of this study show a promising potential of the soft pumps in heart replacements. Further work, focused on increasing blood flow and in turn aortic pressure is required. © 2017 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

[Percutaneous catheter-based implantation of artificial pulmonary valves in patients with congenital heart defects].

PubMed

Wyller, Vegard Bruun; Aaberge, Lars; Thaulow, Erik; Døhlen, Gaute

2011-07-01

Percutaneous catheter-based implantation of artificial heart valves is a new technique that may supplement surgery and which may be used more in the future. We here report our first experience with implantation of artificial pulmonary valves in children with congenital heart defects. Eligible patients were those with symptoms of heart failure combined with stenosis and/or insufficiency in an established artificial right ventricular outflow tract. The valve was inserted through a catheter from a vein in the groin or neck. Symptoms, echocardiography, invasive measurements and angiography were assessed for evaluation of treatment effect. Our treatment results are reported for the period April 2007-September 2009. Ten patients (seven men and three women, median age 17 years) were assessed. The procedure reduced pressure in the right ventricle (p = 0.008) and resolved the pulmonary insufficiency in all patients. The median time in hospital was two days. No patients had complications that were directly associated with the implantation procedure. One patient developed a pseudoaneurysm in the femoral artery, another had a short-lasting fever two days after the procedure and one patient experienced a stent fracture that required surgery 9 months after the implantation. After 6 months all patients had a reduced pressure gradient in the right ventricular outflow tract (p = 0.008), the pulmonary insufficiency had improved (p = 0.006) and they all reported improval of symptoms. These results persisted for at least 24 months for the four patients who were monitored until then. Percutaneous catheter-based implantation of artificial pulmonary valves improves hemodynamics in the right ventricle of selected patients with congenital heart defects. A randomized controlled study should be undertaken to provide a stronger evidence-base for usefulness of this procedure.

Simulation of a pulsatile total artificial heart: Development of a partitioned Fluid Structure Interaction model

NASA Astrophysics Data System (ADS)

Sonntag, Simon J.; Kaufmann, Tim A. S.; Büsen, Martin R.; Laumen, Marco; Linde, Torsten; Schmitz-Rode, Thomas; Steinseifer, Ulrich

2013-04-01

Heart disease is one of the leading causes of death in the world. Due to a shortage in donor organs artificial hearts can be a bridge to transplantation or even serve as a destination therapy for patients with terminal heart insufficiency. A pusher plate driven pulsatile membrane pump, the Total Artificial Heart (TAH) ReinHeart, is currently under development at the Institute of Applied Medical Engineering of RWTH Aachen University.This paper presents the methodology of a fully coupled three-dimensional time-dependent Fluid Structure Interaction (FSI) simulation of the TAH using a commercial partitioned block-Gauss-Seidel coupling package. Partitioned coupling of the incompressible fluid with the slender flexible membrane as well as a high fluid/structure density ratio of about unity led inherently to a deterioration of the stability (‘artificial added mass instability’). The objective was to conduct a stable simulation with high accuracy of the pumping process. In order to achieve stability, a combined resistance and pressure outlet boundary condition as well as the interface artificial compressibility method was applied. An analysis of the contact algorithm and turbulence condition is presented. Independence tests are performed for the structural and the fluid mesh, the time step size and the number of pulse cycles. Because of the large deformation of the fluid domain, a variable mesh stiffness depending on certain mesh properties was specified for the fluid elements. Adaptive remeshing was avoided. Different approaches for the mesh stiffness function are compared with respect to convergence, preservation of mesh topology and mesh quality. The resulting mesh aspect ratios, mesh expansion factors and mesh orthogonalities are evaluated in detail. The membrane motion and flow distribution of the coupled simulations are compared with a top-view recording and stereo Particle Image Velocimetry (PIV) measurements, respectively, of the actual pump.

The Total Artificial Heart in End-Stage Congenital Heart Disease.

PubMed

Villa, Chet R; Morales, David L S

2017-01-01

The development of durable ventricular assist devices (VADs) has improved mortality rates and quality of life in patients with end stage heart failure. While the use of VADs has increased dramatically in recent years, there is limited experience with VAD implantation in patients with complex congenital heart disease (CHD), despite the fact that the number of patients with end stage CHD has grown due to improvements in surgical and medical care. VAD use has been limited in patients with CHD and end stage heart failure due to anatomic (systemic right ventricle, single ventricle, surgically altered anatomy, valve dysfunction, etc.) and physiologic constraints (diastolic dysfunction). The total artificial heart (TAH), which has right and left sided pumps that can be arranged in a variety of orientations, can accommodate the anatomic variation present in CHD patients. This review provides an overview of the potential use of the TAH in patients with CHD.

The Total Artificial Heart in End-Stage Congenital Heart Disease

PubMed Central

Villa, Chet R.; Morales, David L. S.

2017-01-01

The development of durable ventricular assist devices (VADs) has improved mortality rates and quality of life in patients with end stage heart failure. While the use of VADs has increased dramatically in recent years, there is limited experience with VAD implantation in patients with complex congenital heart disease (CHD), despite the fact that the number of patients with end stage CHD has grown due to improvements in surgical and medical care. VAD use has been limited in patients with CHD and end stage heart failure due to anatomic (systemic right ventricle, single ventricle, surgically altered anatomy, valve dysfunction, etc.) and physiologic constraints (diastolic dysfunction). The total artificial heart (TAH), which has right and left sided pumps that can be arranged in a variety of orientations, can accommodate the anatomic variation present in CHD patients. This review provides an overview of the potential use of the TAH in patients with CHD. PMID:28536530

A Physical Heart Failure Simulation System Utilizing the Total Artificial Heart and Modified Donovan Mock Circulation.

PubMed

Crosby, Jessica R; DeCook, Katrina J; Tran, Phat L; Betterton, Edward; Smith, Richard G; Larson, Douglas F; Khalpey, Zain I; Burkhoff, Daniel; Slepian, Marvin J

2017-07-01

With the growth and diversity of mechanical circulatory support (MCS) systems entering clinical use, a need exists for a robust mock circulation system capable of reliably emulating and reproducing physiologic as well as pathophysiologic states for use in MCS training and inter-device comparison. We report on the development of such a platform utilizing the SynCardia Total Artificial Heart and a modified Donovan Mock Circulation System, capable of being driven at normal and reduced output. With this platform, clinically relevant heart failure hemodynamics could be reliably reproduced as evidenced by elevated left atrial pressure (+112%), reduced aortic flow (-12.6%), blunted Starling-like behavior, and increased afterload sensitivity when compared with normal function. Similarly, pressure-volume relationships demonstrated enhanced sensitivity to afterload and decreased Starling-like behavior in the heart failure model. Lastly, the platform was configured to allow the easy addition of a left ventricular assist device (HeartMate II at 9600 RPM), which upon insertion resulted in improvement of hemodynamics. The present configuration has the potential to serve as a viable system for training and research, aimed at fostering safe and effective MCS device use. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Transapical off-pump mitral valve repair. First experience with the NeoChord system in Poland (report of two cases).

PubMed

Wróbel, Krzysztof; Kurnicka, Katarzyna; Zygier, Marcin; Dyk, Wojciech; Wojdyga, Ryszard; Zieliński, Dariusz; Jarzębska, Małgorzata; Juraszyński, Zbigniew; Lichodziejewska, Barbara; Pruszczyk, Piotr; Biederman, Andrzej; Speziali, Giovanni; Kasten, Uwe

2017-01-01

Artificial chord implantation to repair a flail or prolapsing mitral valve leaflet requires open heart surgery and cardiopulmonary bypass. Transapical off-pump artificial chordae implantation is a new surgical technique proposed to treat degenerative mitral valve regurgitation. The procedure is performed using the NeoChord DS1000 system (NeoChord, Inc., St. Louis Park, MN, USA), which facilitates both implantation and lenght adjustment of the artificial chordae under two (2D)- and three (3D)-dimensional transoesophageal echocardiographic (TEE) guidance on a beating heart. Two male patients aged 60 and 55 years with severe mitral regurgitation due to posterior leaflet prolapse underwent transapical off-pump artificial chordae implantation on September 3, 2015. The procedure was performed by left minithoracotomy under general anaesthesia in a cardiac surgical theatre, using 2D and 3D TEE guidance. Early procedural success as confirmed by 3D TEE was achieved in both patients, with implantation of 6 artificial chordae in the first patient and 3 artificial chordae in the second patient. Both procedures were uneventful, and no postoperative complications were noted. The patients were discharged home on the 8th and 6th postoperative day, respectively. The NeoChord DS1000 system allows both implantation and lenght adjustment of artificial chordae under 2D and 3D TEE guidance on a beating heart. Our initial experience in 2 patients with posterior mitral leaflet prolapse indicates that the procedure is feasible and safe.

Worldwide Experience with the Syncardia Total Artificial Heart in the Pediatric Population.

PubMed

Morales, David L S; Lorts, Angela; Rizwan, Raheel; Zafar, Farhan; Arabia, Francisco A; Villa, Chet R

Individual centers have documented the use of the Syncardia Total Artificial Heart (TAH) in adolescents with heart failure; however, the number of patients at any given center is small. Herein, we describe the worldwide experience for all patients ≤21 years old supported with the TAH between May 2005 and May 2015 (n = 43). The number of patients experiencing a positive outcome at 60, 90, and 120 days were 30 (70%), 27 (63%), and 25 (58%), respectively. Successful bridge to transplantation varied by diagnosis, but outcomes reported are similar to adults supported with the TAH or biventricular assist devices.

Further evidence of gaseous embolic material in patients with artificial heart valves.

PubMed

Georgiadis, D; Baumgartner, R W; Karatschai, R; Lindner, A; Zerkowski, H R

1998-04-01

We undertook this study to evaluate the hypothesis that most microemboli signals in patients with artificial heart valves are gaseous, assuming that microemboli counts in cerebral arteries would progressively decline with increasing distance from the generating heart valve. A total of 10 outpatients with CarboMedics (Sulzer Carbomedics Inc., n = 5) and ATS prosthetic heart valves (n = 5) in the aortic (n = 8), mitral (n = 1), or both aortic and mitral positions (n = 1) were recruited. Monitoring was performed simultaneously over the middle and anterior cerebral arteries and the common carotid artery for 30 minutes with the 2 MHZ transducers of a color duplex scanner (common carotid artery) and pulsed-wave Doppler ultrasonography (intracranial arteries). All data were harvested in an eight-channel digital audio tape recorder, and microembolic signal counts were evaluated online by two separate observers. Significantly higher microembolic signal counts were recorded in the common carotid artery (112 [75 to 175]) compared with the middle and anterior cerebral arteries (30 [18 to 36], p < 0.0001). Interobserver variability was satisfactory (k = 0.81). Our results strongly argue for gaseous underlying embolic material in patients with artificial heart valves because bubbles are bound to implode with time.

Sudden death of a middle-aged man with an artificial vagina in situ.

PubMed

Vidanapathirana, Muditha; Ruwanpura, Rohan P; Amararatne, Sriyantha Rrg

2016-01-01

Artificial vaginas are designed to imitate the female sex organ. This is the first reported case in the forensic literature of a man being pronounced dead with an artificial vagina in situ . A middle-aged man was found unconscious in a bathroom when the door was forced open and was pronounced dead on admission. Autopsy revealed that the penis was inside an artificial vagina. There were no injuries, but there were left ventricular hypertrophy, myocardial fibrosis, and narrow coronaries. The cause of death was ascertained as ischemic heart disease due to coronary atherosclerosis and the comments included were no evidence of violence, and ischemic heart disease could have been precipitated due to abnormal sexual activity. If removal of artificial vagina was done before the admission, this circumstance could not have ascertained. Removal of such devices before admission to hospitals could be the reason why such incidents do not come to light.

The total artificial heart for biventricular heart failure and beyond.

PubMed

Kasirajan, Vigneshwar; Tang, Daniel G; Katlaps, Gundars J; Shah, Keyur B

2012-05-01

Treatment options for late-stage biventricular heart failure are limited but include medical therapy with intravenous inotropes, biventricular assist devices (Bi-VADs) and the total artificial heart (TAH). In this manuscript, we review the indications, surgical techniques and outcomes for the TAH. The TAH offers biventricular replacement, rather than 'assistance', as the device is placed orthotopically after excision of the entire ventricular myocardium and all four native valves. In contrast to patients with Bi-VADs, patients with the TAH have no postoperative inotrope requirements, arrhythmias or inflow/outflow cannulae-related complications. Additionally, patients participate in rehabilitation early after device placement and the development of a portable drive may facilitate hospital discharge in the USA. Furthermore, total heart replacement may be ideal for heart failure associated with unique anatomical and mechanical complications. The TAH is an effective therapeutic option for the treatment of patients dying of heart failure who may not be suitable candidates for left ventricular assist devices.

Head MRI

MedlinePlus

... the head; MRI - cranial; NMR - cranial; Cranial MRI; Brain MRI; MRI - brain; MRI - head ... the test, tell your provider if you have: Brain aneurysm clips An artificial heart valves Heart defibrillator ...

Implantation technique of the 50-cm3 SynCardia Total Artificial Heart: does size make a difference?

PubMed

Spiliopoulos, Sotirios; Guersoy, Dilek; Dimitriou, Alexandros Merkourios; Koerfer, Reiner; Tenderich, Gero

2015-01-01

Despite downsizing, implantation technique of the 50-cm(3) SynCardia Total Artificial Heart and settings of the Companion driver remain unchanged. Owing to the absence of de-airing nipples, de-airing procedure is even more crucial and has to be performed carefully. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Design of a portable artificial heart drive system based on efficiency analysis.

PubMed

Kitamura, T

1986-11-01

This paper discusses a computer simulation of a pneumatic portable piston-type artificial heart drive system with a linear d-c-motor. The purpose of the design is to obtain an artificial heart drive system with high efficiency and small dimensions to enhance portability. The design employs two factors contributing the total efficiency of the drive system. First, the dimensions of the pneumatic actuator were optimized under a cost function of the total efficiency. Second, the motor performance was studied in terms of efficiency. More than 50 percent of the input energy of the actuator with practical loads is consumed in the armature circuit in all linear d-c-motors with brushes. An optimal design is: the piston cross-sectional area of 10.5 cm2 cylinder longitudinal length of 10 cm. The total efficiency could be up to 25 percent by improving the gasket to reduce the frictional force.

Liver failure in total artificial heart therapy.

PubMed

Dimitriou, Alexandros Merkourios; Dapunt, Otto; Knez, Igor; Wasler, Andrae; Oberwalder, Peter; Koerfer, Reiner; Tenderich, Gero; Spiliopoulos, Sotirios

2016-07-01

Congestive hepatopathy (CH) and acute liver failure (ALF) are common among biventricular heart failure patients. We sought to evaluate the impact of total artificial heart (TAH) therapy on hepatic function and associated clinical outcomes. A total of 31 patients received a Syncardia Total Artificial Heart. Preoperatively 17 patients exhibited normal liver function or mild hepatic derangements that were clinically insignificant and did not qualify as acute or chronic liver failure, 5 patients exhibited ALF and 9 various hepatic derangements owing to CH. Liver associated mortality and postoperative course of liver values were prospectively documented and retrospectively analyzed. Liver associated mortality in normal liver function, ALF and CH cases was 0%, 20% (P=0.03) and 44.4% (P=0.0008) respectively. 1/17 (5.8%) patients with a normal liver function developed an ALF, 4/5 (80%) patients with an ALF experienced a markedly improvement of hepatic function and 6/9 (66.6%) patients with CH a significant deterioration. TAH therapy results in recovery of hepatic function in ALF cases. Patients with CH prior to surgery form a high risk group with increased liver associated mortality.

Artificial hearts-recent progress: republication of the article published in the Japanese Journal of Artificial Organs.

PubMed

Nishida, Masahiro

2017-09-01

This review was created based on a translation of the Japanese review written in the Japanese Journal of Artificial Organs in 2015 (Vol.44, No. 3, pp.130-135), with some modifications regarding several references published in 2015 or later.

Improvement on the auxiliary total artificial heart (ATAH) left chamber design.

PubMed

Andrade, Aron; Fonseca, Jeison; Legendre, Daniel; Nicolosi, Denys; Biscegli, Jose; Pinotti, Marcos; Ohashi, Yukio; Nosé, Yukihiko

2003-05-01

The auxiliary total artificial heart (ATAH) is an electromechanically driven artificial heart with reduced dimensions, which is able to be implanted in the right thoracic or abdominal cavities of an average human patient without removing the natural heart or the heart neurohumoral inherent control mechanism for the arterial pressure. This device uses a brushless direct current motor and a mechanical actuator (roller screw) to move two diaphragms. The ATAH's beating frequency is regulated through the change of the left preload, based on Frank-Starling's law, assisting the native heart in obtaining adequate blood flow. The ATAH left and right stroke volumes are 38 ml and 34 ml, respectively, giving approximately 5 L/min of cardiac output at 160 bpm. Flow visualization studies were performed in critical areas on the ATAH left chamber. A closed circuit loop was used with water and glycerin (37%) at 25 degrees C. Amberlite particles (80 mesh) were illuminated by a 1 mm planar helium-neon laser light. With left mean preload fixed at 10 mm Hg and the afterload at 100 mm Hg, the heart rate varied from 60 to 200 bpm. Two porcine valves were used on the inlet and outlet ports. The flow pattern images were obtained using a color micro-camera and a video recorder. Subsequently, these images were digitized using a PC computer. A persistent stagnant flow was detected in the left chamber inlet port. After improvement on the left chamber design, this stagnant flow disappeared.

Total Artificial Heart Implantation as a Bridge to Heart Transplantation in an Active Duty Service Member With Amyloid Cardiomyopathy.

PubMed

Scully, Michael S; Wessman, Dylan E; McKee, James M; Francisco, Gregory M; Nayak, Keshav R; Kobashigawa, Jon A

2017-03-01

Cardiac involvement by light-chain (AL) amyloid occurs in up to 50% of patients with primary AL amyloidosis. The prognosis of amyloid heart disease is poor with 1-year survival rates of 35 to 40%. Historically, heart transplantation was considered controversial for patients with AL amyloid cardiomyopathy (CM) given the systemic nature of the disease and poor survival. We present a case report of an active duty service member diagnosed with advanced cardiac amyloid who underwent total artificial heart transplant as a bridge to heart transplant and eventual autologous stem cell transplant. A 47-year-old active duty male initially evaluated for atypical chest pain was found to have severe concentric left ventricular hypertrophy on echocardiogram but normal voltage on electrocardiogram. Cardiac magnetic resonance imaging, laboratory studies, and bone marrow biopsy established the diagnosis of cardiac amyloidosis. At the time of diagnosis, the patient's prognosis was very poor with a median survival of 5 months on the basis of the Mayo Clinic revised prognostic staging system for amyloidosis. The patient developed rapidly progressive left ventricular dysfunction and heart failure leading to cardiac arrest. The patient received a total artificial heart as a bridge to orthotopic heart and kidney transplantation and eventual stem cell transplant. He continues to be in remission and has a fair functional capacity without restriction in activities of daily living or moderate exercise. Amyloid CM is a rare and devastating disease. The natural course of the disease has made heart transplant in these patients controversial. Modern advancements in chemotherapies and advanced heart failure treatments have improved outcomes for select patients with AL amyloid CM undergoing heart transplantation. There is ongoing research seeking improvement in treatment options and outcomes for patients with this deadly disease. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

Virtual instrument: remote control and monitoring of an artificial heart driver

NASA Astrophysics Data System (ADS)

Nguyen, An H.; Farrar, David

1993-07-01

A development of a virtual instrument based on the top-down model approach for an artificial heart driver is presented. Driver parameters and status were being dynamically updated on the virtual system at the remote station. The virtual system allowed the remote operator to interact with the physical heart driver as if he/she were at the local station. Besides use as an effective training tool, the system permits an expert operator to monitor and also control the Thoratec heart driver from a distant location. We believe that the virtual instrument for biomedical devices in general and for the Thoratec heart driver in particular, not only improves system reliability but also opens up a real possibility in reducing medical cost. Utilizing the top-down scheme developed recently for telerobotics, realtime operation in both instrument display and remote communication were possible via a low bandwidth telephone medium.

Biomedical engineering support. Final report, June 15, 1971--June 30, 1979

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kolff, W.J.; Sandquist, G.; Olsen, D.B.

On June 15, 1971 the Institute for Biomedical Engineering at the University of Utah contracted with the USAEC to provide biomedical support for an Artificial Heart Program. The goal of the program was to conceive, design, construct and test a prototype artificial heart system powered by an implantable radioisotope heat source. The system would serve as a total artificial heart for animal experiments and for studies directed at developing a total heart replacement system for humans. The major responsibilities of the Institute during the eight year contract period were to design, construct and test all blood handling components of themore » system and prove in vivo accommodation, performance and adequacy of the system in experimental animals. Upon completion of development of the Implantable Version of the Bench Model Blood Pump, a long series of comprehensive in vitro and in vivo experiments were conducted. In vivo experiments with the system conducted in calves demonstrated the general accommodation, adequate performance and good capacity to sustain the calf as a heart model for up to 36 days. During the more successful in vivo experiments the implanted calves were able to eat, drink, stand, exercise on a treadmill, and exhibited normal blood chemistry and pulmonary function.« less

Control system for an artificial heart

NASA Technical Reports Server (NTRS)

Gebben, V. D.; Webb, J. A., Jr.

1970-01-01

Inexpensive industrial pneumatic components are combined to produce control system to drive sac-type heart-assistance blood pump with controlled pulsatile pressure that makes pump rate of flow sensitive to venous /atrial/ pressure, while stroke is centered about set operating point and pump is synchronized with natural heart.

Extracorporeal total artificial heart as bailout surgery.

PubMed

Perrodin, Stéphanie F; Muller, Olivier; Gronchi, Fabrizio; Liaudet, Lucas; Hullin, Roger; Kirsch, Matthias

2017-03-01

We report the use of a total extracorporeal heart for uncontrolled bleeding following a proximal left anterior descending artery perforation, using two centrifugal ventricular assist devices after heart explantation. The literature describing similar techniques and patient outcomes for this "bailout" technique are reviewed. © 2017 Wiley Periodicals, Inc.

History of the Kolff Laboratory turbine driven electrohydraulic artificial heart.

PubMed

Topaz, S R; Flinders, T; Topaz, H A; Jones, D

1998-11-01

The concept of an electrically powered total artificial heart has been pursued by Dr. Kolff and his associates since the 1960s. Since the 1980s these efforts have been concentrated upon the development of the electrohydraulic total artificial heart, a turbine pump powered by a brushless DC motor. Dr. Kolff realized the benefits of pulsatile flow and device response to Starling's Law, and these concepts have formed the basis of subsequent design decisions. Design iterations have both solved existing problems and exposed new challenges. The current device design is greatly improved over early attempts due to the incorporation of technologies that have recently become available as the result of progress in the fields of materials and electronics and due to the lessons learned over many years of research under the guidance of Dr. Kolff. This article describes, from its inception, the last major research project of Dr. Kolff prior to his retirement. The discussion centers around development, problems and their solutions, and the reasoning for given solutions.

STUDIES IN RESUSCITATION: I. THE GENERAL CONDITIONS AFFECTING RESUSCITATION, AND THE RESUSCITATION OF THE BLOOD AND OF THE HEART

PubMed Central

Pike, F. H.; Guthrie, C. C.; Stewart, G. N.

1908-01-01

Our results may be briefly summarized: 1. Blood, when defibrinated, soon loses its power to maintain the activity of the higher nervous centers, and its nutritive properties for all tissues quickly diminish. 2. Artificial fluids, as a substitute for blood, are not satisfactory. 3. The proper oxygenation of the blood is an indispensable adjunct in the resuscitation of an animal. 4. The heart usually continues to beat for some minutes after it ceases to affect a mercury manometer, and resuscitation of it within this period by extra-thoracic massage and artificial respiration is sometimes successful. 5. Resuscitation of the heart by direct massage is the most certain method at our command. 6. A proper blood-pressure is an indispensable condition for the continued normal activity of the heart. 7. Anæsthetics, hemorrhage and induced currents applied to the heart render resuscitation more difficult than asphyxia alone. PMID:19867138

"And the Beat Goes Ona... Building Artificial Hearts in the Classroom.

ERIC Educational Resources Information Center

Brock, David L.

2000-01-01

Among the many ideas and theories in anatomy and physiology, one particular topic provides all the potential benefits of learning about the human body: the circulatory system, specifically the heart. Describes a distinctive way to study circulation and the heart that allows students to explore the basic principles of vertebrate anatomy and…

Application of a PExSim for modeling a POLVAD artificial heart and the human circulatory system with left ventricle assistance

NASA Astrophysics Data System (ADS)

Siewnicka, Alicja; Fajdek, Bartlomiej; Janiszowski, Krzysztof

2010-01-01

This paper presents a model of the human circulatory system with the possible addition of a parallel assist device, which was developed for the purpose of artificial heart monitoring. Information about an identification experiment of an extracorporeal ventricle assist device POLVAD is included. The modelling methods applied and the corresponding functional blocks in a PExSim package are presented. The results of the simulation for physiological conditions, left ventricle failure and pathological conditions with parallel assistance are included.

Use of Pulmonary Arteriovenous Extracorporeal Membrane Oxygenation in Conjunction with the Total Artificial Heart

PubMed Central

Behrens, Lindsey G.; Goodale, Nicole L.; Turek, Joseph W.; Bates, Michael J.

2015-01-01

The temporary total artificial heart (TAH-t) is approved for destination therapy or bridge to transplant and is associated with improved survival rates before and after transplantation [1]. Postoperatively, patients with the TAH-t may experience acute respiratory failure requiring significant respiratory support. Pulmonary arteriovenous extracorporeal membrane oxygenation (ECMO) has the capabilities to provide this support while minimizing the risks of barotrauma or oxygen toxicity [2]. This report presents a novel cannulation technique for ECMO to provide support for patients after the placement of the TAH-t. PMID:25910839

Prototype Development of an Implantable Compliance Chamber for a Total Artificial Heart.

PubMed

Schmitz, Stephanie; Unthan, Kristin; Sedlaczek, Marc; Wald, Felix; Finocchiaro, Thomas; Spiliopoulos, Sotirios; Koerfer, Reiner; Steinseifer, Ulrich

2017-02-01

At our institute a total artificial heart is being developed. It is directly actuated by a linear drive in between two ventricles, which comprise membranes to separate the drive and blood flow. A compliance chamber (CC) is needed to reduce pressure peaks in the ventricles and to increase the pump capacity. Therefore, the movement of the membrane is supported by applying a negative pressure to the air volume inside the drive unit. This study presents the development of the implantable CC which is connected to the drive unit of the total artificial hearts (TAH). The anatomical fit of the CC is optimized by analyzing CT data and adapting the outer shape to ensure a proper fit. The pressure peaks are reduced by the additional volume and the flexible membrane of the CC. The validation measurements of change in pressure peaks and flow are performed using the complete TAH system connected to a custom mock circulation loop. Using the CC, the pressure peaks could be damped below 5 mm Hg in the operational range. The flow output was increased by up to 14.8% on the systemic side and 18.2% on the pulmonary side. The described implantable device can be used for upcoming chronic animal trials. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Heart rate and leukocytes after air and ground transportation in artificially ventilated neonates: a prospective observational study.

PubMed

Grosek, Stefan; Mlakar, Gorazd; Vidmar, Ivan; Ihan, Alojz; Primozic, Janez

2009-01-01

To evaluate the effect of interhospital air and ground transportation of artificially ventilated neonates on heart rate and peripheral blood leukocyte counts. Prospective, observational study. Level III multidisciplinary Neonatal and Pediatric Intensive Care Unit. Fifty-eight near-term artificially ventilated transported neonates between May 2006 and April 2007. Day-helicopter, day- and night-ground transportation. Heart rate at retrieval, on admission to the ICU and 1 h later, and peripheral blood leukocyte counts on admission and 1 d later were compared. Fifteen neonates were transported by helicopter during the daytime (D-HEL), 20 by daytime ground and 23 by nighttime ground transportation (D-GROUND, N-GROUND). No differences in delivery mode, birth weight, gestational age, gender, primary diagnoses for transportation, response time and duration of transportation were found between the groups. Similarly, no differences in pH, pCO(2), blood pressure and skin temperature at retrieval and on admission to the ICU were found between the three groups. The mean heart rate at retrieval did not differ significantly, while on arrival in the ICU and 1 h later the D-GROUND group of patients showed a significantly higher mean heart rate compared to the D-HEL and N-GROUND groups. Moreover, leukocyte counts on arrival in the ICU showed significantly higher leukocyte counts in the D-GROUND group of patients compared to the D-HEL group of patients. These results demonstrate that there is an association between daytime ground transportation and higher heart rate and peripheral blood leukocytes.

Antithrombotic Therapy in Atrial Fibrillation Associated with Valvular Heart Disease: Executive Summary of a Joint Consensus Document from the European Heart Rhythm Association (EHRA) and European Society of Cardiology Working Group on Thrombosis, Endorsed by the ESC Working Group on Valvular Heart Disease, Cardiac Arrhythmia Society of Southern Africa (CASSA), Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), South African Heart (SA Heart) Association and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE).

PubMed

Lip, Gregory Y H; Collet, Jean Philippe; de Caterina, Raffaele; Fauchier, Laurent; Lane, Deirdre A; Larsen, Torben B; Marin, Francisco; Morais, Joao; Narasimhan, Calambur; Olshansky, Brian; Pierard, Luc; Potpara, Tatjana; Sarrafzadegan, Nizal; Sliwa, Karen; Varela, Gonzalo; Vilahur, Gemma; Weiss, Thomas; Boriani, Giuseppe; Rocca, Bianca

2017-12-01

Management strategies for patients with atrial fibrillation (AF) in association with valvular heart disease (VHD) have been less informed by randomized trials, which have largely focused on ‘non-valvular AF’ patients. Thromboembolic risk also varies according to valve lesion and may also be associated with CHA2DS2-VASc score risk factor components, rather than only the valve disease being causal. Given the need to provide expert recommendations for professionals participating in the care of patients presenting with AF and associated VHD, a task force was convened by the European Heart Rhythm Association (EHRA) and European Society of Cardiology (ESC) Working Group (WG) on Thrombosis, with representation from the ESC WG on Valvular Heart Disease, Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), South African Heart (SA Heart) Association and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE) with the remit to comprehensively review the published evidence, and to produce a consensus document on the management of patients with AF and associated VHD, with up-to-date consensus statements for clinical practice for different forms of VHD, based on the principles of evidence-based medicine. This is an executive summary of a consensus document which proposes that the term ‘valvular AF’ is outdated and given that any definition ultimately relates to the evaluated practical use of oral anticoagulation (OAC) type, we propose a functional EHRA (Evaluated Heartvalves, Rheumatic or Artificial) categorization in relation to the type of OAC use in patients with AF, as follows: (1) EHRA (Evaluated Heartvalves, Rheumatic or Artificial) type 1 VHD, which refers to AF patients with ‘VHD needing therapy with a vitamin K antagonist (VKA)’ and (2) EHRA (Evaluated Heartvalves, Rheumatic or Artificial) type 2 VHD, which refers to AF patients with ‘VHD needing therapy with a VKA or a non-VKA oral anticoagulant also taking into consideration CHA2DS2-VASc score risk factor components.

What about My Child and Rheumatic Fever?

MedlinePlus

... damaged heart valves. This infection is called “infective endocarditis.”You can help reduce the risk for this ... clean and cavities filled can help prevent infective endocarditis. • a history of endocarditis. • an artificial heart valve. • ...

Artificial neural network for normal, hypertensive, and preeclamptic pregnancy classification using maternal heart rate variability indexes.

PubMed

Tejera, Eduardo; Jose Areias, Maria; Rodrigues, Ana; Ramõa, Ana; Manuel Nieto-Villar, Jose; Rebelo, Irene

2011-09-01

A model construction for classification of women with normal, hypertensive and preeclamptic pregnancy in different gestational ages using maternal heart rate variability (HRV) indexes. In the present work, we applied the artificial neural network for the classification problem, using the signal composed by the time intervals between consecutive RR peaks (RR) (n = 568) obtained from ECG records. Beside the HRV indexes, we also considered other factors like maternal history and blood pressure measurements. The obtained result reveals sensitivity for preeclampsia around 80% that increases for hypertensive and normal pregnancy groups. On the other hand, specificity is around 85-90%. These results indicate that the combination of HRV indexes with artificial neural networks (ANN) could be helpful for pregnancy study and characterization.

Effects of graded load of artificial gravity on cardiovascular functions in humans.

PubMed

Iwase, Satoshi; Fu, Qi; Narita, Kenichi; Morimoto, Eiichi; Takada, Hiroki; Mano, Tadaaki

2002-12-01

An artificial gravity and ergometric exercise loading device for human use was manufactured. It has the capacity of a max 2 G-load at the heart level, and a max 150 W of work-load. Eight subjects (six completed) were subjected to four repeated trials with or without 20 W ergometric exercise. Anti-G score, defined as the G-load x running time to the endpoint, was significantly higher in the exercise trials than standing trials. Heart rate (HR), mean arterial pressure (MAP), thoracic fluid index (TFI) were significantly superior during the exercise trials. Artificial gravity by centrifuge at 1.2 or 1.4 G with 40 or 60 W of ergometric workload may be an excellent countermeasure against cardiovascular deconditioning after long exposure to microgravity.

Renal Function Recovery with Total Artificial Heart Support.

PubMed

Quader, Mohammed A; Goodreau, Adam M; Shah, Keyur B; Katlaps, Gundars; Cooke, Richard; Smallfield, Melissa C; Tchoukina, Inna F; Wolfe, Luke G; Kasirajan, Vigneshwar

2016-01-01

Heart failure patients requiring total artificial heart (TAH) support often have concomitant renal insufficiency (RI). We sought to quantify renal function recovery in patients supported with TAH at our institution. Renal function data at 30, 90, and 180 days after TAH implantation were analyzed for patients with RI, defined as hemodialysis supported or an estimated glomerular filtration rate (eGFR) less than 60 ml/min/1.73 m. Between January 2008 and December 2013, 20 of the 46 (43.5%) TAH recipients (age 51 ± 9 years, 85% men) had RI, mean preoperative eGFR of 48 ± 7 ml/min/1.73 m. Renal function recovery was noted at each follow-up interval: increment in eGFR (ml/min/1.73 m) at 30, 90, and 180 days was 21 ± 35 (p = 0.1), 16.5 ± 18 (p = 0.05), and 10 ± 9 (p = 0.1), respectively. Six patients (30%) required preoperative dialysis. Of these, four recovered renal function, one remained on dialysis, and one died. Six patients (30%) required new-onset dialysis. Of these, three recovered renal function and three died. Overall, 75% (15 of 20) of patients' renal function improved with TAH support. Total artificial heart support improved renal function in 75% of patients with pre-existing significant RI, including those who required preoperative dialysis.

The 50/50 cc Total Artificial Heart Trial: Extending the Benefits of the Total Artificial Heart to Underserved Populations.

PubMed

Wells, Dennis; Villa, Chet R; Simón Morales, David Luís

2017-01-01

While use of the total artificial heart (TAH) is growing, the use of the device is not uniform across the gender and age spectrum because the vast majority of implants are in adult males. SynCardia has recently developed a smaller 50 cc TAH that was designed to accommodate patients with a body surface area as low as 1.2 m 2 (potentially even lower using virtual implantation). Herein, we describe the early use of the 50 cc TAH (10 implants in the US and 18 outside the US). Twenty-eight devices have been implanted worldwide. Nineteen (68%) patients were female, 4 (14%) were 21 years of age or younger, and 2 (7%) had a diagnosis of congenital heart disease (1 Fontan). The smallest patient, by body surface area, was 1.35 m 2 . Six patients (21%) have been placed on the Freedom Driver, all of whom have survived. Fourteen patients (50%) have had a positive outcome to date. The development of the 50 cc TAH has expanded the population of patients who may benefit from TAH support and thus may help improve outcomes for patients who have had limited biventricular support options to date. Copyright © 2017 Elsevier Inc. All rights reserved.

An expert system based on principal component analysis, artificial immune system and fuzzy k-NN for diagnosis of valvular heart diseases.

PubMed

Sengur, Abdulkadir

2008-03-01

In the last two decades, the use of artificial intelligence methods in medical analysis is increasing. This is mainly because the effectiveness of classification and detection systems have improved a great deal to help the medical experts in diagnosing. In this work, we investigate the use of principal component analysis (PCA), artificial immune system (AIS) and fuzzy k-NN to determine the normal and abnormal heart valves from the Doppler heart sounds. The proposed heart valve disorder detection system is composed of three stages. The first stage is the pre-processing stage. Filtering, normalization and white de-noising are the processes that were used in this stage. The feature extraction is the second stage. During feature extraction stage, wavelet packet decomposition was used. As a next step, wavelet entropy was considered as features. For reducing the complexity of the system, PCA was used for feature reduction. In the classification stage, AIS and fuzzy k-NN were used. To evaluate the performance of the proposed methodology, a comparative study is realized by using a data set containing 215 samples. The validation of the proposed method is measured by using the sensitivity and specificity parameters; 95.9% sensitivity and 96% specificity rate was obtained.

An intelligent remote monitoring system for artificial heart.

PubMed

Choi, Jaesoon; Park, Jun W; Chung, Jinhan; Min, Byoung G

2005-12-01

A web-based database system for intelligent remote monitoring of an artificial heart has been developed. It is important for patients with an artificial heart implant to be discharged from the hospital after an appropriate stabilization period for better recovery and quality of life. Reliable continuous remote monitoring systems for these patients with life support devices are gaining practical meaning. The authors have developed a remote monitoring system for this purpose that consists of a portable/desktop monitoring terminal, a database for continuous recording of patient and device status, a web-based data access system with which clinicians can access real-time patient and device status data and past history data, and an intelligent diagnosis algorithm module that noninvasively estimates blood pump output and makes automatic classification of the device status. The system has been tested with data generation emulators installed on remote sites for simulation study, and in two cases of animal experiments conducted at remote facilities. The system showed acceptable functionality and reliability. The intelligence algorithm also showed acceptable practicality in an application to animal experiment data.

Examination of mitral regurgitation with a goat heart model for the development of intelligent artificial papillary muscle.

PubMed

Shiraishi, Y; Yambe, T; Yoshizawa, M; Hashimoto, H; Yamada, A; Miura, H; Hashem, M; Kitano, T; Shiga, T; Homma, D

2012-01-01

Annuloplasty for functional mitral or tricuspid regurgitation has been made for surgical restoration of valvular diseases. However, these major techniques may sometimes be ineffective because of chamber dilation and valve tethering. We have been developing a sophisticated intelligent artificial papillary muscle (PM) by using an anisotropic shape memory alloy fiber for an alternative surgical reconstruction of the continuity of the mitral structural apparatus and the left ventricular myocardium. This study exhibited the mitral regurgitation with regard to the reduction in the PM tension quantitatively with an originally developed ventricular simulator using isolated goat hearts for the sophisticated artificial PM. Aortic and mitral valves with left ventricular free wall portions of isolated goat hearts (n=9) were secured on the elastic plastic membrane and statically pressurized, which led to valvular leaflet-papillary muscle positional change and central mitral regurgitation. PMs were connected to the load cell, and the relationship between the tension of regurgitation and PM tension were measured. Then we connected the left ventricular specimen model to our hydraulic ventricular simulator and achieved hemodynamic simulation with the controlled tension of PMs.

[Artificial heart--turbo type blood pump for long-term use].

PubMed

Akamatsu, Teruaki

2003-05-01

Shortage of donor heart for transplantation necessitates long-term artificial assist heart. Turbo-pump is smaller, simpler and cheaper than the pulsatile displacement type pump, but the turbo-pump has defect of thrombus formation at the shaft seal. Our centrifugal pump with magnetically suspended impellers overcomes this defect and is ready for clinical trials now. The structures and functions are described and are compared with the other newly-developed pump of the same kinds with us. And also the pumps of centrifugal type and axial-type, of which impellers are supported by pivots, are reviewed briefly from the stand point for long-term use. Other pumps are referred too: pumps with hydrodynamic bearing and a pump with the shaft seal which is washed and cooled by saline solution.

Role of total artificial heart in the management of heart transplant rejection and retransplantation: case report and review.

PubMed

Kalya, Anantharam; Jaroszewski, Dawn; Pajaro, Octavio; Scott, Robert; Gopalan, Radha; Kasper, Diane; Arabia, Francisco

2013-01-01

Cardiac allograft rejection and failure may require mechanical circulatory support as bridge-to-retransplantation. Prognosis in this patient group is poor and implantable ventricular assist devices have had limited success due to organ failure associated with the high dose immunosuppression required to treat ongoing rejection. We present a case from our institution and the world-wide experience utilizing the SynCardia CardioWest Total Artificial Heart (TAH-t; SynCardia Systems, Inc., Tucson, AZ, USA) for replacement of the failing graft, recovery of patient and end-organ failure with ultimate bridge to retransplantation. We present our experience and review of world-wide experience for use of TAH-t in this type patient. © 2013 John Wiley & Sons A/S.

Artificial heart for humanoid robot using coiled SMA actuators

NASA Astrophysics Data System (ADS)

Potnuru, Akshay; Tadesse, Yonas

2015-03-01

Previously, we have presented the design and characterization of artificial heart using cylindrical shape memory alloy (SMA) actuators for humanoids [1]. The robotic heart was primarily designed to pump a blood-like fluid to parts of the robot such as the face to simulate blushing or anger by the use of elastomeric substrates for the transport of fluids. It can also be used for other applications. In this paper, we present an improved design by using high strain coiled SMAs and a novel pumping mechanism that uses sequential actuation to create peristalsis-like motions, and hence pump the fluid. Various placements of actuators will be investigated with respect to the silicone elastomeric body. This new approach provides a better performance in terms of the fluid volume pumped.

Design and Evaluation of a Fully Implantable Control Unit for Blood Pumps

PubMed Central

Unthan, Kristin; Gräf, Felix; Laumen, Marco; Finocchiaro, Thomas; Sommer, Christoph; Lanmüller, Hermann; Steinseifer, Ulrich

2015-01-01

As the number of donor hearts is limited while more and more patients suffer from end stage biventricular heart failure, Total Artificial Hearts become a promising alternative to conventional treatment. While pneumatic devices sufficiently supply the patients with blood flow, the patient's quality of life is limited by the percutaneous pressure lines and the size of the external control unit. This paper describes the development of the control unit of the ReinHeart, a fully implantable Total Artificial Heart. General requirements for any implantable control unit are defined from a technical and medical point of view: necessity of a Transcutaneous Energy Transmission, autonomous operation, safety, geometry, and efficiency. Based on the requirements, a prototype is designed; it incorporates a LiFePo4 battery pack with charger, a rectifier for transcutaneous energy transmission, the motor's driver electronics, and a microcontroller which monitors and controls all functions. In validation tests, the control unit demonstrated a stable operation on TET and battery supply and a safe switching from one supply to the other. The overall mean efficiency is 14% on TET and 22% on battery supply. The control unit is suitable for chronic animal trials of the ReinHeart. PMID:26583095

Total Artificial Heart as Bridge to Heart Transplantation in Chagas Cardiomyopathy: Case Report.

PubMed

Ruzza, A; Czer, L S C; De Robertis, M; Luthringer, D; Moriguchi, J; Kobashigawa, J; Trento, A; Arabia, F

2016-01-01

Chagas disease (CD) is becoming an increasingly recognized cause of dilated cardiomyopathy outside of Latin America, where it is endemic, due to population shifts and migration. Heart transplantation (HTx) is a therapeutic option for end-stage cardiomyopathy due to CD, but may be considered a relative contraindication due to potential reactivation of the causative organism with immunosuppression therapy. The total artificial heart (TAH) can provide mechanical circulatory support in decompensated patients with severe biventricular dysfunction until the time of HTx, while avoiding immunosuppressive therapy and removing the organ most affected by the causative organism. We report herein a patient with CD and severe biventricular dysfunction, who had mechanical circulatory support with a TAH for more than 6 months, followed by successful orthotopic HTx and treatment with benznidazole for 3 months. The patient had no evidence of recurrent disease in the transplanted heart based on endomyocardial biopsy up to 1 year post-transplantation, and remains alive more than 30 months after insertion of a TAH and 24 months after HTx. Copyright © 2016 Elsevier Inc. All rights reserved.

[PULMONARY COMPLICATIONS IN CHILDREN, OPERATED ON FOR INBORN HEART FAILURES IN THE ARTIFICIAL BLOOD CIRCULATION ENVIRONMENT].

PubMed

Moshkivska, L V; Nastenko, E A; Golovenko, O S; Lazoryshynets, V V

2015-11-01

The risk factors of pulmonary complications occurrence were analyzed in children, operated on for inborn heart failures in atrificial blood circulation environment. Pulmonary complications rate and the risk factors of their occurrence were analyzed.

Numerical Model of Full Cardiac Cycle Hemodynamics in a Total Artificial Heart and the Effect of Its Size on Platelet Activation

PubMed Central

Marom, Gil; Chiu, Wei-Che; Crosby, Jessica R.; DeCook, Katrina J.; Prabhakar, Saurabh; Horner, Marc; Slepian, Marvin J.; Bluestein, Danny

2014-01-01

The SynCardia total artificial heart (TAH) is the only FDA approved device for replacing hearts in patients with congestive heart failure. It pumps blood via pneumatically driven diaphragms and controls the flow with mechanical valves. While it has been successfully implanted in more than 1,300 patients, its size precludes implantation in smaller patients. This study’s aim was to evaluate the viability of scaled-down TAHs by quantifying thrombogenic potentials from flow patterns. Simulations of systole were first conducted with stationary valves, followed by an advanced full-cardiac-cycle model with moving valves. All the models included deforming diaphragms and platelet suspension in the blood flow. Flow stress-accumulations were computed for the platelet trajectories and thrombogenic potentials were assessed. The simulations successfully captured complex flow patterns during various phases of the cardiac-cycle. Increased stress-accumulations, but within the safety margin of acceptable thrombogenicity, were found in smaller TAHs, indicating that they are clinically viable. PMID:25354999

The dynamic cardiac biosimulator: A method for training physicians in beating-heart mitral valve repair procedures.

PubMed

Leopaldi, Alberto M; Wrobel, Krzysztof; Speziali, Giovanni; van Tuijl, Sjoerd; Drasutiene, Agne; Chitwood, W Randolph

2018-01-01

Previously, cardiac surgeons and cardiologists learned to operate new clinical devices for the first time in the operating room or catheterization laboratory. We describe a biosimulator that recapitulates normal heart valve physiology with associated real-time hemodynamic performance. To highlight the advantages of this simulation platform, transventricular extruded polytetrafluoroethylene artificial chordae were attached to repair flail or prolapsing mitral valve leaflets. Guidance for key repair steps was by 2-dimensional/3-dimensional echocardiography and simultaneous intracardiac videoscopy. Multiple surgeons have assessed the use of this biosimulator during artificial chordae implantations. This simulation platform recapitulates normal and pathologic mitral valve function with associated hemodynamic changes. Clinical situations were replicated in the simulator and echocardiography was used for navigation, followed by videoscopic confirmation. This beating heart biosimulator reproduces prolapsing mitral leaflet pathology. It may be the ideal platform for surgeon and cardiologist training on many transcatheter and beating heart procedures. Copyright © 2017 The American Association for Thoracic Surgery. All rights reserved.

Cardiopulmonary Resuscitation in Adults and Children With Mechanical Circulatory Support: A Scientific Statement From the American Heart Association.

PubMed

Peberdy, Mary Ann; Gluck, Jason A; Ornato, Joseph P; Bermudez, Christian A; Griffin, Russell E; Kasirajan, Vigneshwar; Kerber, Richard E; Lewis, Eldrin F; Link, Mark S; Miller, Corinne; Teuteberg, Jeffrey J; Thiagarajan, Ravi; Weiss, Robert M; O'Neil, Brian

2017-06-13

Cardiac arrest in patients on mechanical support is a new phenomenon brought about by the increased use of this therapy in patients with end-stage heart failure. This American Heart Association scientific statement highlights the recognition and treatment of cardiovascular collapse or cardiopulmonary arrest in an adult or pediatric patient who has a ventricular assist device or total artificial heart. Specific, expert consensus recommendations are provided for the role of external chest compressions in such patients. © 2017 American Heart Association, Inc.

The OregonHeart Total Artificial Heart: Design and Performance on a Mock Circulatory Loop.

PubMed

Glynn, Jeremy; Song, Howard; Hull, Bryan; Withers, Stanley; Gelow, Jill; Mudd, James; Starr, Albert; Wampler, Richard

2017-10-01

Widespread use of heart transplantation is limited by the scarcity of donor organs. Total artificial heart (TAH) development has been pursued to address this shortage, especially to treat patients who require biventricular support. We have developed a novel TAH that utilizes a continuously spinning rotor that shuttles between two positions to provide pulsatile, alternating blood flow to the systemic and pulmonary circulations without artificial valves. Flow rates and pressures generated by the TAH are controlled by adjusting rotor speed, cycle frequency, and the proportion of each cycle spent pumping to either circulation. To validate the design, a TAH prototype was placed in a mock circulatory loop that simulates vascular resistance, pressure, and compliance in normal and pathophysiologic conditions. At a systemic blood pressure of 120/80 mm Hg, nominal TAH output was 7.4 L/min with instantaneous flows reaching 17 L/min. Pulmonary artery, and left and right atrial pressures were all maintained within normal ranges. To simulate implant into a patient with severe pulmonary hypertension, the pulmonary vascular resistance of the mock loop was increased to 7.5 Wood units. By increasing pump speed to the pulmonary circulation, cardiac output could be maintained at 7.4 L/min as mean pulmonary artery pressure increased to 56 mm Hg while systemic blood pressures remained normal. This in vitro testing of a novel, shuttling TAH demonstrated that cardiac output could be maintained across a range of pathophysiologic conditions including pulmonary hypertension. These experiments serve as a proof-of-concept for the design, which has proceeded to in vivo testing. © 2017 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Current progress in the development of a totally implantable Gyro centrifugal artificial heart.

PubMed

Takami, Y; Ohtsuka, G; Mueller, J; Ebner, M; Tayama, E; Ohashi, Y; Taylor, D; Fernandes, J; Schima, H; Schmallegger, H; Wolner, E; Nosé, Y

1998-01-01

A totally implantable centrifugal artificial heart has been developed using a miniaturized pivot bearing supported centrifugal pump (Gyro PI pump). The authors report current progress in its development. The Gyro PI-601 has a priming volume of 20 ml, weighs 100 g, has a height of 60 mm, and has a diameter of 65 mm. This pump can provide 8 L/min against 150 mmHg at 2,250 rpm. It is driven by an miniaturized DC brushless motor with the coils fixed in a plastic mold that is waterproof and made of titanium (weight, 204 g; height, 18 mm; diameter, 65 mm). In this centrifugal artificial heart, two Gyro PI pumps are implanted independently to replace cardiac function without resecting the native heart. Its anatomic and surgical feasibility were confirmed experimentally. The Gyro PI-601 was implanted as a right or left ventricular assist device in the preperitoneal space of five calves. All five tests proceeded without any thromboembolic symptoms. One of five tests was extended more than 1 month to confirm the long-term feasibility of the Gyro PI-601 pump system. Based on the satisfactory results of the in vivo tests, the material conversion of the Gyro PI from polycarbonate to titanium alloy (Ti-6A1-4V) was undertaken to improve its biocompatibility for long-term implantation.

Experimental study of physical properties of artificial materials for the development of the tissue-engineered valvular heart apparatus in comparison with biological analogs

NASA Astrophysics Data System (ADS)

Chiryatyeva, Aleksandra; Trebushat, Dmitry; Prokhorokhin, Aleksei; Khakhalkin, Vladimir; Andreev, Mark; Novokhreschenov, Aleksei; Kretov, Evgeny

2017-12-01

Cardiovascular diseases are the leading cause of death worldwide. Valvular heart disease often requires valve repair or replacement. Today, surgery uses xenograft—porcine or bovine pericardium. However, bioprosthetic valves do not ensure sufficient durability. We investigated 0.6% glutaraldehyde-treated porcine pericardium to define its properties. Using a tensile test stand, we studied characteristics of the polymeric material—expanded polytetrafluoroethylene (ePTFE)—and compared it to xenopericardium. The artificial material provides a better durability; it has higher elastic modulus and ultimate tensile strength. However, ePTFE samples demonstrated direction anisotropy due to extrusion features. It requires the enhancement of quality of the ePTFE sheet or investigation of other polymeric materials to find the adequate replacement for bioprosthetic heart valves.

Cardiopulmonary exercise testing responses to different external portable drivers in a patient with a CardioWest Total Artificial Heart.

PubMed

Tarzia, Vincenzo; Braccioni, Fausto; Bortolussi, Giacomo; Buratto, Edward; Gallo, Michele; Bottio, Tomaso; Vianello, Andrea; Gerosa, Gino

2016-06-01

Management of patients treated with CardioWest Total Artificial Heart (CW-TAH) as a bridge to heart transplantation (HTx) is complicated by difficulties in determining the optimal timing of transplantation. We present a case of a 53-year-old man supported as an outpatient with a CW-TAH, whose condition deteriorated following exchange of the portable driver. The patient was followed-up with serial cardiopulmonary exercise testing (CPET) which demonstrated a fall of peak VO2 to below 12 ml/kg/min following driver substitution, and the patient was subsequently treated with urgent orthotopic HTx. This case highlights the potential utility of CPET as a means for monitoring and indicating timing of HTx in patients with CW-TAH, as well as the potential for clinical deterioration following portable driver substitution.

Vacuum generation in pneumatic artificial heart drives with a specially designed ejector system.

PubMed

Schima, H; Huber, L; Spitaler, F

1990-06-01

To improve the filling characteristics of pneumatically driven membrane artificial hearts (AHs), a vacuum is applied during diastole. This paper describes an ejector system for AH-drivers based on the Venturi effect, which was designed for this purpose. It provides vacuums of more than -40 mmHg at flow rates up to 50 l/min requiring a supplying primary gas pressure of less than 150 kPa (1140 mmHg). Under normal working conditions, the necessary supply flow was less than 5l/min. The device is small, cheap, quiet and fail-safe, and has been evaluated successfully in experimental and clinical use.

Design and analysis of a field modulated magnetic screw for artificial heart

NASA Astrophysics Data System (ADS)

Ling, Zhijian; Ji, Jinghua; Wang, Fangqun; Bian, Fangfang

2017-05-01

This paper proposes a new electromechanical energy conversion system, called Field Modulated Magnetic Screw (FMMS) as a high force density linear actuator for artificial heart. This device is based on the concept of magnetic screw and linear magnetic gear. The proposed FMMS consists of three parts with the outer and inner carrying the radially magnetized helically permanent-magnet (PM), and the intermediate having a set of helically ferromagnetic pole pieces, which modulate the magnetic fields produced by the PMs. The configuration of the newly designed FMMS is presented and its electromagnetic performances are analyzed by using the finite-element analysis, verifying the advantages of the proposed structure.

Potential woodpecker nest trees through artificial inoculation of heart rots

Treesearch

Richard N. Conner; James G. Dickson; J. Howard Williamson

1983-01-01

We suggest that the fungus Spongipellis pachyodon might be used to artificially create suitable hardwood nest trees for woodpeckers in both young and older trees and when supplies of potential nest trees are limited. Sizes of trees suitable for inoculation, inoculation heights, and densities of snags are suggested for six species of woodpeckers.

Mathematical Model Analysis of Heart-Arterial Interaction in Hypertension

DTIC Science & Technology

2001-10-25

conscious dogs with dilated cardiomyopathy ,” ! " # , vol. 260, pp. H1903-H1911, 1991. [7] P. Segers, N...with data measured in the isolated canine [14] or cat [15] heart, pumping into an artificial load or in the intact sheep [16] and human [7]. Left...instantaneous pressure-volume ratio of the canine left ventricle and effects of epinephrine and heart rate on the ratio,” , vol. 32, pp. 314

AbioCor totally implantable artificial heart. How will it impact hospitals?

PubMed

2002-09-01

Although heart transplantation remains the most effective treatment for severe heart failure, there are far fewer donor hearts available than there are patients who could benefit from them. One approach to addressing this shortfall is the total artificial heart, or TAH. To date, however, no TAH design has been able to achieve one of the ultimate goals of heart replacement: to allow a patient to live a reasonably normal life without being connected to external machinery. A new design, the AbioCor TAH developed by Abiomed Inc., may make this goal achievable. Thanks to a power system that transfers energy through the skin without the aid of wires, the AbioCor--currently undergoing clinical trials in the United States--allows the patient to be completely mobile. The lack of transcutaneous wires also eliminates the primary source of the infections that have plagued TAH patients in the past. Though it is not without drawbacks, the AbioCor could represent a crucial advance in TAH technology. In this Technology Overview, we describe the operation of the AbioCor and discuss its likely impact on hospitals if it is approved for marketing in the United States. We also discuss a related cardiac-support technology: ventricular assist devices (VADs), which may also be used for permanent cardiac support someday.

Numerical model of total artificial heart hemodynamics and the effect of its size on stress accumulation.

PubMed

Marom, Gil; Chiu, Wei-Che; Slepian, Marvin J; Bluestein, Danny

2014-01-01

The total artificial heart (TAH) is a bi-ventricular mechanical circulatory support device that replaces the heart in patients with end-stage congestive heart failure. The device acts as blood pump via pneumatic activation of diaphragms altering the volume of the ventricular chambers. Flow in and out of the ventricles is controlled by mechanical heart valves. The aim of this study is to evaluate the flow regime in the TAH and to estimate the thrombogenic potential during systole. Toward that goal, three numerical models of TAHs of differing sizes, that include the deforming diaphragm and the blood flow from the left chamber to the aorta, are introduced. A multiphase model with injection of platelet particles is employed to calculate their trajectories. The shear stress accumulation in the three models are calculated along the platelets trajectories and their probability density functions, which represent the `thrombogenic footprint' of the device are compared. The calculated flow regime successfully captures the mitral regurgitation and the flows that open and close the aortic valve during systole. Physiological velocity magnitudes are found in all three models, with higher velocities and increased stress accumulation predicted for smaller devices.

Observation of cavitation in a mechanical heart valve in a total artificial heart.

PubMed

Lee, Hwansung; Tsukiya, Tomonori; Homma, Akihiko; Kamimura, Tadayuki; Takewa, Yoshiaki; Nishinaka, Tomohiro; Tatsumi, Eisuke; Taenaka, Yoshiyuki; Takano, Hisateru; Kitamura, Soichiro

2004-01-01

Recently, cavitation on the surface of mechanical heart valves has been studied as a cause of fractures occurring in implanted mechanical heart valves. The cause of cavitation in mechanical heart valves was investigated using the 25 mm Medtronic Hall valve and the 23 mm Omnicarbon valve. Closing of these valves in the mitral position was simulated in an electrohydraulic totally artificial heart. Tests were conducted under physiologic pressures at heart rates from 60 to 100 beats per minute with cardiac outputs from 4.8 to 7.7 L/min. The disk closing motion was measured by a laser displacement sensor. A high-speed video camera was used to observe the cavitation bubbles in the mechanical heart valves. The maximum closing velocity of the Omnicarbon valve was faster than that of the Medtronic Hall valve. In both valves, the closing velocity of the leaflet, used as the cavitation threshold, was approximately 1.3-1.5 m/s. In the case of the Medtronic Hall valve, cavitation bubbles were generated by the squeeze flow and by the effects of the venturi and the water hammer. With the Omnicarbon valve, the cavitation bubbles were generated by the squeeze flow and the water hammer. The mechanism leading to the development of cavitation bubbles depended on the valve closing velocity and the valve stop geometry. Most of the cavitation bubbles were observed around the valve stop and were generated by the squeeze flow.

Total Artificial Heart and Chronic Haemodialysis: A Possible Bridge to Transplantation?

PubMed

Demiselle, Julien; Besson, Virginie; Sayegh, Johnny; Subra, Jean-François; Augusto, Jean-François

2016-01-01

Total artificial heart (TAH) device is sometimes necessary to treat end stage heart failure (HF). After surgery, renal impairment can occur with the need of renal replacement therapy. We report the case of a 51-year-old man who was treated with conventional hemodialysis (HD) while on support with TAH. The patient underwent HD while on TAH support during 14 months. He benefited from conventional HD, 6 sessions per week. HD sessions were well tolerated, and patient's condition and quality of life improved significantly. The main difficulty was to maintain red blood cell level because of chronic hemolysis due to TAH, which required repetitive blood transfusions, resulting in a high rate of human leukocyte antigen sensitization. Unfortunately, the patient died of mesenteric ischemia due to anticoagulation under dosing. We conclude that HD treatment is possible despite TAH and should be considered in patients with both end stage renal and HF. © 2016 S. Karger AG, Basel.

The Japanese artificial organs scene: current status.

PubMed

Mitamura, Yoshinori; Murabayashi, Shun

2005-08-01

Artificial organs and regenerative medicine are the subjects of very active research and development (R&D) in Japan and various artificial organs are widely used in patients. Results of the R&D are presented at the annual conference of the Japanese Society for Artificial Organs (JSAO). Progress in the fields of artificial organs and regenerative medicine are reviewed annually in the Japanese Journal of Artificial Organs. The official English-language journal of JSAO, Journal of Artificial Organs, also publishes many original articles by Japanese researchers. Although the annual conference and the publications of JSAO provide the world with update information on artificial organs and regenerative medicine in Japan, the information is not always understood appropriately in the rest of the world, mainly due to language problems. This article therefore introduces the current status of artificial organs and regenerative medicine in Japan. Artificial hearts and metabolic support systems are reviewed here and other interesting areas such as regenerative medicine can be found elsewhere.

Hybrid Continuous-Flow Total Artificial Heart.

PubMed

Fox, Carson; Chopski, Steven; Murad, Nohra; Allaire, Paul; Mentzer, Robert; Rossano, Joseph; Arabia, Francisco; Throckmorton, Amy

2018-05-01

Clinical studies using total artificial hearts (TAHs) have demonstrated that pediatric and adult patients derive quality-of-life benefits from this form of therapy. Two clinically-approved TAHs and other pumps under development, however, have design challenges and limitations, including thromboembolic events, neurologic impairment, infection risk due to large size and percutaneous drivelines, and lack of ambulation, to name a few. To address these limitations, we are developing a hybrid-design, continuous-flow, implantable or extracorporeal, magnetically-levitated TAH for pediatric and adult patients with heart failure. This TAH has only two moving parts: an axial impeller for the pulmonary circulation and a centrifugal impeller for the systemic circulation. This device will utilize the latest generation of magnetic bearing technology. Initial geometries were established using pump design equations, and computational modeling provided insight into pump performance. The designs were the basis for prototype manufacturing and hydraulic testing. The study results demonstrate that the TAH is capable of delivering target blood flow rates of 1-6.5 L/min with pressure rises of 1-92 mm Hg for the pulmonary circulation and 24-150 mm Hg for the systemic circulation at 1500-10 000 rpm. This initial design of the TAH was successful and serves as the foundation to continue its development as a novel, more compact, nonthrombogenic, and effective therapeutic alternative for infants, children, adolescents, and adults with heart failure. © 2018 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

First clinical use of a bioprosthetic total artificial heart: report of two cases.

PubMed

Carpentier, Alain; Latrémouille, Christian; Cholley, Bernard; Smadja, David M; Roussel, Jean-Christian; Boissier, Elodie; Trochu, Jean-Noël; Gueffet, Jean-Pierre; Treillot, Michèle; Bizouarn, Philippe; Méléard, Denis; Boughenou, Marie-Fazia; Ponzio, Olivier; Grimmé, Marc; Capel, Antoine; Jansen, Piet; Hagège, Albert; Desnos, Michel; Fabiani, Jean-Noël; Duveau, Daniel

2015-10-17

The development of artificial hearts in patients with end-stage heart disease have been confronted with the major issues of thromboembolism or haemorrhage. Since valvular bioprostheses are associated with a low incidence of these complications, we decided to use bioprosthetic materials in the construction of a novel artificial heart (C-TAH). We report here the device characteristics and its first clinical applications in two patients with end-stage dilated cardiomyopathy. The aim of the study was to evaluate safety and feasibility of the CARMAT TAH for patients at imminent risk of death from biventricular heart failure and not eligible for transplant. The C-TAH is an implantable electro-hydraulically actuated pulsatile biventricular pump. All components, batteries excepted, are embodied in a single device positioned in the pericardial sac after excision of the native ventricles. We selected patients admitted to hospital who were at imminent risk of death, having irreversible biventricular failure, and not eligible for heart transplantation, from three cardiac surgery centres in France. The C-TAH was implanted in two male patients. Patient 1, aged 76 years, had the C-TAH implantation on Dec 18, 2013; patient 2, aged 68 years, had the implantation on Aug 5, 2014. The cardiopulmonary bypass times for C-TAH implantation were 170 min for patient 1 and 157 min for patient 2. Both patients were extubated within the first 12 postoperative hours and had a rapid recovery of their respiratory and circulatory functions as well as a normal mental status. Patient 1 presented with a tamponade on day 23 requiring re-intervention. Postoperative bleeding disorders prompted anticoagulant discontinuation. The C-TAH functioned well with a cardiac output of 4·8-5·8 L/min. On day 74, the patient died due to a device failure. Autopsy did not detect any relevant thrombus formation within the bioprosthesis nor the different organs, despite a 50-day anticoagulant-free period. Patient 2 experienced a transient period of renal failure and a pericardial effusion requiring drainage, but otherwise uneventful postoperative course. He was discharged from the hospital on day 150 after surgery with a wearable system without technical assistance. After 4 months at home, the patient suffered low cardiac output. A change of C-TAH was attempted but the patient died of multiorgan failure. This preliminary experience could represent an important contribution to the development of total artificial hearts using bioprosthetic materials. CARMAT SA. Copyright © 2015 Elsevier Ltd. All rights reserved.

Initial Experience with IV Ketamine Infusion for Treatment of Post Sternotomy Pain in a Patient with a Total Artificial Heart.

PubMed

Maher, Dermot P; Loyferman, Rusty; Yumul, Roya; Louy, Charles

2015-01-01

The implantation of total artificial hearts (TAH) via midline sternotomy for the treatment of severe biventricular cardiac dysfunction is associated with complex postoperative pain management. Ketamaine increases blood pressure by raising sympathetic outflow and cardiac output; however, ketamine is a direct vasodilator on isolated arterial tissues. In the setting of a TAH with a mechanically fixed cardiac output, a ketamine infusion for postoperative pain control has the potential to decrease blood pressure due to direct arterial vasodilation. We present the initial experience with a ketamine infusion in a patient with a TAH with minimal observed decreases in blood pressure and significantly improved postoperative pain.

Estimation of Filling and Afterload Conditions by Pump Intrinsic Parameters in a Pulsatile Total Artificial Heart.

PubMed

Cuenca-Navalon, Elena; Laumen, Marco; Finocchiaro, Thomas; Steinseifer, Ulrich

2016-07-01

A physiological control algorithm is being developed to ensure an optimal physiological interaction between the ReinHeart total artificial heart (TAH) and the circulatory system. A key factor for that is the long-term, accurate determination of the hemodynamic state of the cardiovascular system. This study presents a method to determine estimation models for predicting hemodynamic parameters (pump chamber filling and afterload) from both left and right cardiovascular circulations. The estimation models are based on linear regression models that correlate filling and afterload values with pump intrinsic parameters derived from measured values of motor current and piston position. Predictions for filling lie in average within 5% from actual values, predictions for systemic afterload (AoPmean , AoPsys ) and mean pulmonary afterload (PAPmean ) lie in average within 9% from actual values. Predictions for systolic pulmonary afterload (PAPsys ) present an average deviation of 14%. The estimation models show satisfactory prediction and confidence intervals and are thus suitable to estimate hemodynamic parameters. This method and derived estimation models are a valuable alternative to implanted sensors and are an essential step for the development of a physiological control algorithm for a fully implantable TAH. Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

The evolving role of the total artificial heart in the management of end-stage congenital heart disease and adolescents.

PubMed

Ryan, Thomas D; Jefferies, John L; Zafar, Farhan; Lorts, Angela; Morales, David L S

2015-01-01

Advances in medical therapies have yielded improvement in morbidity and a decrease in mortality for patients with congenital heart disease, both surgically palliated and uncorrected. An unintended consequence is a cohort of adolescent and adult patients with heart failure who require alternative therapies. One intriguing option is placement of a total artificial heart (TAH) either as a bridge to transplant or as a destination therapy. Of the 1091 Jarvik-7 type TAH (Symbion, CardioWest and SynCardia) placed between 1985 and 2012, only 24 have been performed in patients with congenital heart disease, and a total of 51 were placed in patients younger than 21. At our institution, the SynCardia TAH was implanted in a 19-year-old patient with cardiac allograft failure because of chronic rejection and related multisystem organ failure including need for hemodialysis. Over the next year, she was nutritionally and physically rehabilitated, as were her end organs, allowing her to come off dialysis, achieve normal renal function and eventually be successfully transplanted. Given the continued growth of adolescent and adult congenital heart disease populations with end-stage heart failure, the TAH may offer therapeutic options where previously there were few. In addition, smaller devices such as the SynCardia 50/50 will open the door for applications in smaller children. The Freedom Driver offers the chance for patients to leave the hospital with a TAH, as does the AbioCor, which is a fully implantable TAH option. In this report, we review the history of the TAH and potential applications in adolescent patients and congenital heart disease.

Automatic Emboli Detection System for the Artificial Heart

NASA Astrophysics Data System (ADS)

Steifer, T.; Lewandowski, M.; Karwat, P.; Gawlikowski, M.

In spite of the progress in material engineering and ventricular assist devices construction, thromboembolism remains the most crucial problem in mechanical heart supporting systems. Therefore, the ability to monitor the patient's blood for clot formation should be considered an important factor in development of heart supporting systems. The well-known methods for automatic embolus detection are based on the monitoring of the ultrasound Doppler signal. A working system utilizing ultrasound Doppler is being developed for the purpose of flow estimation and emboli detection in the clinical artificial heart ReligaHeart EXT. Thesystem will be based on the existing dual channel multi-gate Doppler device with RF digital processing. A specially developed clamp-on cannula probe, equipped with 2 - 4 MHz piezoceramic transducers, enables easy system setup. We present the issuesrelated to the development of automatic emboli detection via Doppler measurements. We consider several algorithms for the flow estimation and emboli detection. We discuss their efficiency and confront them with the requirements of our experimental setup. Theoretical considerations are then met with preliminary experimental findings from a) flow studies with blood mimicking fluid and b) in-vitro flow studies with animal blood. Finally, we discuss some more methodological issues - we consider several possible approaches to the problem of verification of the accuracy of the detection system.

Simulation of heart infarction by laser microbeams and induction of arrhythmias by optical tweezers

NASA Astrophysics Data System (ADS)

Perner, Birgit; Monajembashi, Shamci; Rapp, Alexander; Wollweber, Leo; Greulich, Karl Otto

2004-10-01

Laser microbeam and optical tweezers were used for micromanipulation of a heart tissue model consisting of embryonic chicken cardiomyocytes and bibroblasts. Using the laser microbeam a would was created, i.e. a sort of artificial heart infarction was generated. The first steps of wound repair were observed by live cell imaging. A complete filling of teh would primarily by migrating fibroblasts but not by cardiomyocytes was detected 18 hours after wounding. In another set of experiments erythrocyte mediated force application (EMFA) by optical tweezers was applied for optomechanical manipulatoin of cardiomyocytes and fibroblasts. Here we demonstrate induction of dramatic distrubances of calcium waves in a group of synchronously beating cardiomyocytes by an optomechanical input that results in cellular deformation. Surprisingly, it was found that putatively non-excitable fibroblasts respond to this mechanical stress with calcium oscillations. The results reported here indicate that the induction of artificial heart infarction can provide insights into healing processes after mycardial injury. EMFA is capable to examine effects of myocardial overload and to provide important information about processes triggered by mechanical stress on the level of single or very few cells. As a perspective, the preseneted techniques may be used to study the influence of drugs on wound healing and coordination of beating in the heart.

Research to improve the accuracy of determining the stroke volume of an artificial ventricle using the wavelet transform

NASA Astrophysics Data System (ADS)

Grad, Leszek; Murawski, Krzysztof; Sulej, Wojciech

2017-08-01

In the article we presented results obtained during research, which are the continuation of work on the use of artificial neural networks to determine the relationship between the view of the membrane and the stroke volume of the blood chamber of the mechanical prosthetic heart. The purpose of the research was to increase the accuracy of determining the blood chamber volume. Therefore, the study was focused on the technique of the features that the image extraction gives. During research we used the wavelet transform. The achieved results were compared to the results obtained by other previous methods. Tests were conducted on the same mechanical prosthetic heart model used in previous experiments.

Future Prospects for the Total Artificial Heart.

PubMed

Sunagawa, Gengo; Horvath, David J; Karimov, Jamshid H; Moazami, Nader; Fukamachi, Kiyotaka

2016-01-01

A total artificial heart (TAH) is the sole remaining option for patients with biventricular failure who cannot be rescued by left ventricular assist devices (LVADs) alone. However, the pulsatile TAH in clinical use today has limitations: large pump size, unknown durability, required complex anticoagulation regimen, and association with significant postsurgical complications. That pump is noisy; its large pneumatic driving lines traverse the body, with bulky external components for its drivers. Continuous-flow pumps, which caused a paradigm shift in the LVAD field, have already contributed to the rapidly evolving development of TAHs. Novel continuous-flow TAHs are only in preclinical testing or developmental stages. We here review the current state of TAHs, with recommended requirements for the TAH of the future.

Proposal of a new electromechanical total artificial heart: the TAH Serpentina.

PubMed

Sauer, I M; Frank, J; Bücherl, E S

1999-03-01

A new type of energy converter for an electro-mechanical total artificial heart (TAH) based on the principle of a unidirectional moving motor is described. Named the TAH Serpentina, the concept consists of 2 major parts, a pendulum shaped movable element fixed on one side using a joint bearing and a special shaped drum cam. Pusher plates are mounted flexibly to the crossbar of the pendulum. A motor drives the special shaped drum cam linked to the pendulum through a ball bearing. The circular motion of the unidirectional moving brushless DC motor is transferred into the linear motion of the pendulum to drive the pusher plates. Using a crossbar with a variable length, the stroke of the pendulum and therefore the displaced blood volume is alterable. To achieve a variable length, an electric driven screw thread or a hydraulic system is possible. Comparable to the natural heart, cardiac output would be determined by frequency and stroke volume.

Computation of incompressible viscous flows through artificial heart devices with moving boundaries

NASA Technical Reports Server (NTRS)

Kiris, Cetin; Rogers, Stuart; Kwak, Dochan; Chang, I.-DEE

1991-01-01

The extension of computational fluid dynamics techniques to artificial heart flow simulations is illustrated. Unsteady incompressible Navier-Stokes equations written in 3-D generalized curvilinear coordinates are solved iteratively at each physical time step until the incompressibility condition is satisfied. The solution method is based on the pseudo compressibility approach and uses an implicit upwind differencing scheme together with the Gauss-Seidel line relaxation method. The efficiency and robustness of the time accurate formulation of the algorithm are tested by computing the flow through model geometries. A channel flow with a moving indentation is computed and validated with experimental measurements and other numerical solutions. In order to handle the geometric complexity and the moving boundary problems, a zonal method and an overlapping grid embedding scheme are used, respectively. Steady state solutions for the flow through a tilting disk heart valve was compared against experimental measurements. Good agreement was obtained. The flow computation during the valve opening and closing is carried out to illustrate the moving boundary capability.

Psychophysiological Effects of a Single, Short, and Moderately Bright Room Light Exposure on Mildly Depressed Geriatric Inpatients: A Pilot Study.

PubMed

Canazei, Markus; Pohl, Wilfried; Bauernhofer, Kathrin; Papousek, Ilona; Lackner, Helmut K; Bliem, Harald R; Marksteiner, Josef; Weiss, Elisabeth M

2017-01-01

Light interventions typically exert their mood-related effects during morning bright light exposures over several weeks. Evidence about immediate ambient room light effects on depressed individuals is still sparse. The present study aimed at examining the acute effects of a single moderately bright room light exposure on mood, and behavioural and cardiac stress reactions of mildly depressed geriatric inpatients during a short cognitive stimulation and while resting. Twenty-one inpatients were tested in a balanced cross-over design on 2 consecutive days under either conventional room light (standard light) or artificial sunlight conditions for 30 min. Room illumination was implemented with an artificial skylight, which perfectly imitated solar indoor illumination (e.g., cloudless sky and bright artificial sun). Light-induced changes of mood, heart rate, and heart rate variability were recorded while performing a perseveration test (acted as cognitive stimulation) twice. Additionally, light-related behaviour was observed during a resting period between the cognitive tests and various subjective ratings were obtained. Compared to standard light, exposure to artificial sunlight had a subjective calming effect over time (p = 0.029) as well as decreased heart rate and increased vagal tone (root mean squared of successive inter-beat intervals), both under cognitive workload and in resting conditions. Effect sizes of reported cardiac reactions were large. Cognitive variables were not influenced by light. Additionally, under the higher corneal illuminance of the artificial sunlight, patients perceived stronger glare (p = 0.030) and kept their eyes closed for longer times (p = 0.033) during the resting period. However, patients did not avoid bright light exposure while resting but voluntarily stayed within the area directly lit by the artificial sun nearly all the time (97%). To our knowledge, this study for the first time demonstrated immediate psychophysiological effects of a single, short room light exposure in mildly depressed geriatric inpatients during a short cognitive stimulation and while resting. The findings complement reported evidence on immediate alerting and mood-related effects of bright light exposures. © 2017 S. Karger AG, Basel.

Histopathology Image Analysis in Two Long-Term Animal Experiments with Helical Flow Total Artificial Heart.

PubMed

Wotke, Jiri; Homolka, Pavel; Vasku, Jaromír; Dobsak, Petr; Palanova, Petra; Mrkvicova, Veronika; Konecny, Petr; Soska, Vladimir; Pohanka, Michal; Novakova, Marie; Yurimoto, Terumi; Saito, Itsuro; Inoue, Yusuke; Isoyama, Takashi; Abe, Yusuke

2016-12-01

Histopathological analysis can provide important information in long-term experiments with total artificial heart (TAH). Recently, a new type of blood pump, the helical flow total artificial heart (HF-TAH) was developed. This study aimed to investigate the changes in selected vital organs in animal experiments with implanted HF-TAH. Samples from lung, liver, and kidneys from two female goats (No. 1301 and No. 1304) with implanted HF-TAH were analyzed. Tissue samples were fixed in 10% formaldehyde and 4 µm thick transverse sections were stained with hematoxylin-eosin (HE). Additional staining was done for detection of connective tissue (Masson-Goldner stain) and for detection of iron (hemosiderin) deposits (Perls stain). Sections were scanned at 100× and 500× magnification with a light microscope. Experiment no. 1301 survived 100 days (cause of termination was heavy damage of the right pump); experimental goat no.1304 survived 68 days and was sacrificed due to severe right hydrodynamic bearing malfunction. Histopathological analysis of liver samples proved signs of chronic venostasis with limited focal necrotic zones. Dilated tubules, proteinaceous material in tubular lumen, and hemosiderin deposits were detected in kidney samples. Contamination of the organs by embolized micro-particles was suspected at the autopsy after discovery of visible damage (scratches) of the pump impeller surface (made from titanium alloy) in both experiments. Sporadic deposits of foreign micro-particles (presumably titanium) were observed in most of the analyzed parenchymal organs. However, the described deposits were not in direct connection with inflammatory reactions in the analyzed tissues. Histopathological analysis showed the presence of minimal contamination of the lung, kidney, and liver tissue samples by foreign material (titanium very likely). The analysis showed only limited pathological changes, especially in liver and kidneys, which might be attributed to the influence of artificial perfusion often observed in chronic TAH experiments. © 2016 Wiley Periodicals, Inc. and International Center for Artificial Organs and Transplantation.

THE MECHANICAL HEART ON THE MEDICAL HORIZON

PubMed Central

Kolff, Jacob; Olsen, Don B.; Kolff, Willem J.

1975-01-01

Progress in materials and design of a total artificial heart has lengthened survival times from 1½ hours in 1958 to 3 months in 1974. During those years various limiting factors were found and analyzed. Remaining limitations encountered in a 3-month survivor were localized thrombosis within the blood chambers and infection along drive lines into the mediastinum. Images PMID:15215913

Impact of INTERMACS Profile on Clinical Outcomes for Patients Supported With the Total Artificial Heart.

PubMed

Shah, Keyur B; Thanavaro, Kristin L; Tang, Daniel G; Quader, Mohammed A; Mankad, Anit K; Tchoukina, Inna; Thacker, Leroy R; Smallfield, Melissa C; Katlaps, Gundars; Hess, Michael L; Cooke, Richard H; Kasirajan, Vigneshwar

2016-11-01

Insufficient data delineate outcomes for Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) profile 1 patients with the total artificial heart (TAH). We studied 66 consecutive patients implanted with the TAH at our institution from 2006 through 2012 and compared outcome by INTERMACS profile. INTERMACS profiles were adjudicated retrospectively by a reviewer blinded to clinical outcomes. Survival after TAH implantation at 6 and 12 months was 76% and 71%, respectively. INTERMACS profile 1 patients had decreased 6-month survival on the device compared with those in profiles 2-4 (74% vs 95%, log rank: P = .015). For the 50 patients surviving to heart transplantation, the 1-year posttransplant survival was 82%. There was no difference in 1-year survival when comparing patients in the INTERMACS 1 profile with less severe profiles (79% vs 84%; log rank test P = .7; hazard ratio [confidence interval] 1.3 [0.3-4.8]). Patients implanted with the TAH as INTERMACS profile 1 had reduced survival to transplantation compared with less sick profiles. INTERMACS profile at the time of TAH implantation did not affect 1-year survival after heart transplantation. Copyright © 2016 Elsevier Inc. All rights reserved.

4D optical coherence tomography of aortic valve dynamics in a murine mouse model ex vivo

NASA Astrophysics Data System (ADS)

Schnabel, Christian; Jannasch, Anett; Faak, Saskia; Waldow, Thomas; Koch, Edmund

2015-07-01

The heart and its mechanical components, especially the heart valves and leaflets, are under enormous strain during lifetime. Like all highly stressed materials, also these biological components undergo fatigue and signs of wear, which impinge upon cardiac output and in the end on health and living comfort of affected patients. Thereby pathophysiological changes of the aortic valve leading to calcific aortic valve stenosis (AVS) as most frequent heart valve disease in humans are of particular interest. The knowledge about changes of the dynamic behavior during the course of this disease and the possibility of early stage diagnosis could lead to the development of new treatment strategies and drug-based options of prevention or therapy. ApoE-/- mice as established model of AVS versus wildtype mice were introduced in an ex vivo artificially stimulated heart model. 4D optical coherence tomography (OCT) in combination with high-speed video microscopy were applied to characterize dynamic behavior of the murine aortic valve and to characterize dynamic properties during artificial stimulation. OCT and high-speed video microscopy with high spatial and temporal resolution represent promising tools for the investigation of dynamic behavior and their changes in calcific aortic stenosis disease models in mice.

Artificial organs and transplantation.

PubMed

Splendiani, G; Cipriani, S; Vega, A; Casciani, C U

2003-05-01

Nowadays artificial devices are not able to totally and undefinitely replace the loss of function of all vital organs and artificial organs can be used only to bridge the time to transplantation, which must be considered the first choice in the therapeutical approach for many chronic diseases. Since general population aging process is leading to an increase of organ demand, the gap between performed and requested transplantation is hard to fill. Xenotransplantation is nowadays only an experimental alternative solution and we have to do our best using available artificial organs to increase and improve the survival of patients waiting for transplantation. In this meeting we particularly dealt about organ function replacing therapy, especially regarding the kidney, heart, liver, pancreas and ear.

Arrhythmia

MedlinePlus

... medicine. Severe cases require additional treatment, such as: Artificial pacemaker. The electronic device is placed under the skin on your chest. It helps your heart maintain a regular beat. Cardiac defibrillation. A brief ...

Heat Generation in Axial and Centrifugal Flow Left Ventricular Assist Devices.

PubMed

Yost, Gardner; Joseph, Christine Rachel; Royston, Thomas; Tatooles, Antone; Bhat, Geetha

Despite increasing use of left ventricular assist devices (LVADs) as a surgical treatment for advanced heart failure in an era of improved outcomes with LVAD support, the mechanical interactions between these pumps and the cardiovascular system are not completely understood. We utilized an in vitro mock circulatory loop to analyze the heat production incurred by operation of an axial flow and centrifugal flow LVAD. A HeartMate II and a HeartWare HVAD were connected to an abbreviated flow loop and were implanted in a viscoelastic gel. Temperature was measured at the surface of each LVAD. Device speed and fluid viscosity were altered and, in the HeartMate II, as artificial thrombi were attached to the inflow stator, impeller, and outflow stator. The surface temperatures of both LVADs increased in all trials and reached a plateau within 80 minutes of flow initiation. Rate of heat generation and maximum system temperature were greater when speed was increased, when viscosity was increased, and when artificial thrombi were attached to the HeartMate II impeller. Normal operation of these two widely utilized LVADs results in appreciable heat generation in vitro. Increased pump loading resulted in more rapid heat generation, which was particularly severe when a large thrombus was attached to the impeller of the HeartMate II. While heat accumulation in vivo is likely minimized by greater dissipation in the blood and soft tissues, focal temperature gains with the pump housing of these two devices during long-term operation may have negative hematological consequences.

Pulmonary Hypertension After Heart Transplantation in Patients Bridged with the Total Artificial Heart.

PubMed

Shah, Rachit; Patel, Dhavalkumar B; Mankad, Anit K; Rennyson, Stephen L; Tang, Daniel G; Quader, Mohammed A; Smallfield, Melissa C; Kasirajan, Vigneshwar; Shah, Keyur B

2016-01-01

Pulmonary hypertension (PH) among heart transplant recipients is associated with an increased risk of mortality. Pulmonary hemodynamics improves after left ventricular assist device (LVAD) implantation; however, the impact of PH before total artificial heart (TAH) implantation on posttransplant hemodynamics and survival is unknown. This is a single center retrospective study aimed to evaluate the impact of TAH implantation on posttransplant hemodynamics and mortality in two groups stratified according to severity of PH: high (≥3 Woods units [WU]) and low (<3 WU) baseline pulmonary vascular resistance (PVR). Hemodynamic data were obtained from right heart catheterization performed at baseline (before TAH) and posttransplant at 1 and 12 months. Patients in the high PVR group (n = 12) experienced improvement in PVR (baseline = 4.31 ± 0.7; 1-month = 1.69 ± 0.7, p < 0.001; 12-month = 48 ± 0.9, p < 0.001) and transpulmonary gradient (baseline = 15.8 ± 3.3; 1-month = 11.57 ± 5.0, p = 0.07; 12-month = 8.50 ± 4.0, p = 0.008) after transplantation, reaching similar values as the low PVR group at 12 months. The filling pressures improved in the high PVR group after heart transplantation (HT), but remained elevated. There was no significant difference in survival between the two groups at 12 months follow-up. Patients with high PVR who are bridged to transplant with TAH had improvement in PVR at 12 months after transplant, and the degree of PVR did not impact posttransplant survival.

Glomerulonephritis

MedlinePlus

... re also more likely to recover quickly. Bacterial endocarditis. Bacteria occasionally can spread through your bloodstream and ... as a damaged or artificial heart valve. Bacterial endocarditis is associated with glomerular disease, but the connection ...

[Flowmetric assessment of coronary bypass grafts in the conditions of artificial circulation and on the beating heart].

PubMed

Bazylev, V V; Nemchenko, E V; Karnakhin, V A; Pavlov, A A; Mikulyak, A I

2016-01-01

Advantages and shortcomings of aortocoronary bypass grafting on the beating heart and in the conditions of artificial circulation (AC) have long been discussed. The data on patency of bypass grafts in the remote period are indicative of comparable results of operations with and without AC or advantages of using AC. In order to determine benefits of each method it is necessary to reveal intraoperative predictors of bypass grafts occlusion in the remote period. We analyzed the results of ultrasound flowmetry of the blood flow through the left internal thoracic artery during bypass grafting of the anterior descending artery with the use of AC and on the beating heart. A retrospective study included a total of 352 patients subdivided into 2 groups: Group One was composed of 120 patients undergoing surgery in the conditions of AC and Group Two comprised 232 patients subjected to similar operations on the beating heart. Blood flow was measured with the help of flowmeter VeryQ MediStim® after termination of AC and inactivation of heparin by protamine, with systolic pressure of 100-110 mm Hg. There were no statistically significant differences between the groups by the diameter and degree of stenosis of the anterior descending artery, diameter of the left internal thoracic artery. The mean volumetric blood flow velocity (Qmean) along the shunts in Group One was higher (p=0.01). No statistically significant differences by the pulsatility index (PI) between the groups were revealed (p=0.2). A conclusion was drawn that coronary bypass grafting of the anterior descending artery by the left internal thoracic artery in the conditions of artificial circulation made it possible to achieve higher volumetric velocity of blood flow through the conduit as compared with operations on the beating heart, with similar resistance index. The immediate results of the operations with the use of the both techniques did not differ.

Non-Nutritive Sweeters (Artificial Sweeteners)

MedlinePlus

... a Healthy Heart Healthy Kids Our Kids Programs Childhood Obesity What is childhood obesity? Overweight in Children BMI in Children Is Childhood Obesity an Issue in Your Home? Addressing your Child's ...

Wireless power transfer for a pacemaker application.

PubMed

Vulfin, Vladimir; Sayfan-Altman, Shai; Ianconescu, Reuven

2017-05-01

An artificial pacemaker is a small medical device that uses electrical impulses, delivered by electrodes contracting the heart muscles, to regulate the beating of the heart. The pacemaker is implanted under the skin, and uses for many years regular non-rechargeable batteries. However, the demand for rechargeable batteries in pacemakers increased, and the aim of this work is to design an efficient charging system for pacemakers.

Development of a microcontroller-based automatic control system for the electrohydraulic total artificial heart.

PubMed

Kim, H C; Khanwilkar, P S; Bearnson, G B; Olsen, D B

1997-01-01

An automatic physiological control system for the actively filled, alternately pumped ventricles of the volumetrically coupled, electrohydraulic total artificial heart (EHTAH) was developed for long-term use. The automatic control system must ensure that the device: 1) maintains a physiological response of cardiac output, 2) compensates for an nonphysiological condition, and 3) is stable, reliable, and operates at a high power efficiency. The developed automatic control system met these requirements both in vitro, in week-long continuous mock circulation tests, and in vivo, in acute open-chested animals (calves). Satisfactory results were also obtained in a series of chronic animal experiments, including 21 days of continuous operation of the fully automatic control mode, and 138 days of operation in a manual mode, in a 159-day calf implant.

Heart failure analysis dashboard for patient's remote monitoring combining multiple artificial intelligence technologies.

PubMed

Guidi, G; Pettenati, M C; Miniati, R; Iadanza, E

2012-01-01

In this paper we describe an Heart Failure analysis Dashboard that, combined with a handy device for the automatic acquisition of a set of patient's clinical parameters, allows to support telemonitoring functions. The Dashboard's intelligent core is a Computer Decision Support System designed to assist the clinical decision of non-specialist caring personnel, and it is based on three functional parts: Diagnosis, Prognosis, and Follow-up management. Four Artificial Intelligence-based techniques are compared for providing diagnosis function: a Neural Network, a Support Vector Machine, a Classification Tree and a Fuzzy Expert System whose rules are produced by a Genetic Algorithm. State of the art algorithms are used to support a score-based prognosis function. The patient's Follow-up is used to refine the diagnosis.

Implantable Medical Devices

MedlinePlus

... Also known as ICD ) - An ICD is a battery-powered device placed under the skin that keeps ... Pacemaker (Also known as Artificial Pacemaker) - A small battery-operated device that helps the heart beat in ...

77 FR 27737 - Procurement List Proposed Additions

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-11

..., pictures, wall art, artificial plants, light fixtures, globes/lenses, trophies/display cases, drapes... Forces Medical Examiner System, Building 115, 115 Purple Heart Drive, Dover AFB, DE. NPA: The Chimes, Inc...

Heart valve surgery

MedlinePlus

... with an artificial valve (this is called the Ross Procedure). This procedure may be useful for people ... valve that does not close all the way will allow blood to leak backwards. This is called ...

Helping the Library Reach Out to the Future

MedlinePlus

... the students asked questions and explored exhibits featuring artificial body parts and recent examples of medical breakthroughs. They saw and touched heart stents, pacemakers, oxygenators (old and new), a coronary ...

Infections in Patients with a Total Artificial Heart Are Common but Rarely Fatal.

PubMed

Hidalgo, Luis F; Shah, Keyur B; Cooke, Richard H; Tang, Daniel G; Kasirajan, Vigneshwar; Cooper, Howard A; Aronow, Wilbert S

Patients who received a total artificial heart (TAH) at Virginia Commonwealth University (VCU) between January 1, 2010 and December 31, 2011 were identified from the VCU Mechanical Circulatory Support Clinical Database. Retrospective data extraction from the medical records was performed from the time of TAH implantation until heart transplantation or death. Infections were classified as confirmed or suspected. Twenty-seven men and five women, mean age 49.5 years (range 24-68 years) received a TAH. The mean duration of TAH support was 225 days (range 1-1,334 days). Of the 32 patients, 4 (12.5%) died and 28 (87.5 %) underwent heart transplantation. Causes of death were pneumonia (n = 1), TAH malfunction (n = 1), refractory cardiogenic shock (n = 1), and respiratory failure (n = 1). Seventy documented and 13 suspected infections developed in 25 patients (78%). The most common sources of infection were urinary tract (n = 26), respiratory tract (n = 18), and bloodstream (n = 11). There were five pump infections and two driveline infections. The number of infections per patient ranged from 0 to 10. Sixteen different pathogens were identified; the most common were: Klebsiella pneumoniae (n = 15), coagulase-negative Staphylococci (n = 10), Enterococcus species (n = 9), and Enterobacter species (n = 8). Mortality directly attributable to infection was infrequent.

Application of the moving-actuator type pump as a ventricular assist device: in vitro and in vivo studies.

PubMed

Lee, H S; Rho, Y R; Park, C Y; Hwang, C M; Kim, W G; Sun, K; Choi, M J; Lee, K K; Cheong, J T; Shim, E B; Min, B G

2002-06-01

A moving actuator type pump has been developed as a multifunctional Korean artificial heart (AnyHeart). The pump consists of a moving actuator as an energy converter, right and left sacs, polymer (or mechanical) valves, and a rigid polyurethane housing. The actuator containing a brushless DC motor moves back and forth on an epicyclical gear train to produce a pendular motion, which compresses both sacs alternately. Of its versatile functions of ventricular assist device and total artificial heart use, we have evaluated the system performance as a single or biventricular assist device through in vitro and in vivo experiments. Pump performance and anatomical feasibility were tested using various animals of different sizes. In the case of single ventricular assist device (VAD) use, one of the sacs remained empty and a mini-compliance chamber was attached to either an outflow or inflow port of the unused sac. The in vitro and in vivo studies show acceptable performance and pump behavior. Further extensive study is required to proceed to human application.

Wireless patient monitoring system for a moving-actuator type artificial heart.

PubMed

Nam, K W; Chung, J; Choi, S W; Sun, K; Min, B G

2006-10-01

In this study, we developed a wireless monitoring system for outpatients equipped with a moving-actuator type pulsatile bi-ventricular assist device, AnyHeart. The developed monitoring system consists of two parts; a Bluetooth-based short-distance self-monitoring system that can monitor and control the operating status of a VAD using a Bluetooth-embedded personal digital assistant or a personal computer within a distance of 10 meters, and a cellular network-based remote monitoring system that can continuously monitor and control the operating status of AnyHeart at any location. Results of in vitro experiments demonstrate the developed system's ability to monitor the operational status of an implanted AnyHeart.

9 CFR 352.7 - Marking inspected products.

Code of Federal Regulations, 2013 CFR

2013-01-01

..., exotic animal tongues, and exotic animal hearts. EC11SE91.031 (2) For application to exotic animal calf... used on shipping containers, bond labels, artificial casings, and other articles with the approval of...

What Is a Total Artificial Heart?

MedlinePlus

... Learn more about getting to NIH Get Email Alerts Receive automatic alerts about NHLBI related news and ... Connect With Us Contact Us Directly Get Email Alerts Receive automatic alerts about NHLBI related news and ...

9 CFR 352.7 - Marking inspected products.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., exotic animal tongues, and exotic animal hearts. EC11SE91.031 (2) For application to exotic animal calf... used on shipping containers, bond labels, artificial casings, and other articles with the approval of...

[The influence of cardiosurgical intervention type and conditions of artificial blood circulation of perioperative dynamics of cardiac biomarkers].

PubMed

Dement'eva, I I; Morozov, Iu A; Charnaia, M A

2013-01-01

125 patients after cardiac surgery operated on with the use of artificial blood circulation (ABC) were followed-up. Blood levels of cardiac protein, binding aliphatic acids and troponin 1 and 3 days after the operation were registered. The study showed that aorta clamping more then 90 minutes and hypothermic perfusion regimen influence cardiomyocites negatively. The state of "surgical trauma" and reperfusional myocardium damage was approximately the same during aortic surgery, myocardium revascularization with the use of aortic clamping and cardioplegia, and correction of the acquired heart disease, according to the dynamics of the studied proteins in blood. The minimal blood level of cardiac protein, binding aliphatic acids after coronary by-pass surgery on the working heart witnesses about negative influence of crystalloid hypothermic cardioplegia on coronary microcirculation.

Routine implantation of cardioverter/defibrillator devices in patients aged 75 years and older with prior myocardial infarction and left ventricular ejection fraction < 30: antagonist viewpoint.

PubMed

Basta, Lofty L

2003-01-01

The Multicenter Automatic Defibrillator Implantation Trial (MADIT II) investigators assert that their results justify the placement of artificial implantable defibrillator cardioverter devices in patients aged 75 years and older with prior myocardial infarction and left ventricular dysfunction (ejection fraction of 30 or less). The authors claim that the results of the trial do not justify this conclusion. The majority of patients were male (84%) and aged 64+/-10 years. Also, 2.8% of patients assigned to the defibrillator group and 1.5% had their device removed. Of the latter subgroup, nine patients (1.3%) received a heart transplant. Twelve had their artificial implantable defibrillator cardioverter device deactivated mostly because of terminal illness. Although the study results show a significant reduction in mortality over the control group (absolute reduction=5.6%), almost the same percentage required hospitalization because of manifestation of congestive heart failure (absolute value 5%; p=0.09). Also, 1.8% had lead problems, 0.7% had infections, and the benefits were only seen after the first year. Caution is needed before the results of this study are applied to a much older cohort comprised mainly of women in whom heart transplant is contraindicated and who have multiple health problems, including cognitive impairment. Artificial implantable cardioverter/defibrillator devices are expensive and this study's results need to be duplicated in other comparable cohorts.

Optimum selection of an implantable secondary battery for an artificial heart by examination of the cycle life test.

PubMed

Okamoto, Eiji; Watanabe, Kazuya; Hashiba, Kunihiro; Inoue, Taku; Iwazawa, Eichi; Momoi, Masato; Hashimoto, Takuya; Mitamura, Yoshinori

2002-01-01

An implantable secondary battery is one of the key components in a total artificial heart system. Because a 2 year cycle life is required, the cycle life of the secondary battery as well as its charge and discharge properties are important parameters for selection of an appropriate battery. We carried out cycle life tests on four kinds of rechargeable batteries (a Ni-MH secondary battery, a Ni-Cd secondary battery, a Li-ion battery with a graphite anode, and a Li-ion battery with a nongraphitizable carbon electrode) to determine their suitability as implanted back-up batteries. Each of the batteries was charge/discharge cycled at 37 degrees C to 39 degrees C using a charge current of 1 C ampere, and they were each fully discharged under either pulsatile discharge loads, which mimicked pulsatile operation, or a nonpulsatile load equivalent to the average of the pulsatile loads. The two Li-ion batteries made by different manufacturers both met the minimum requirement of cycle life of more than 1,500 cycles, considering safety coefficient regardless of the discharge pattern. In addition, the temperature increase of these Li-ion batteries (3 degrees C) was lower than that of Ni-Cd and Ni-MH batteries (15-25 degrees C). Out of these four batteries, the two Li-ion batteries are the most suitable for use in a totally implantable artificial heart system.

Investigation of the Durability of a Diaphragm for a Total Artificial Heart.

PubMed

Gräf, Felix; Rossbroich, Ralf; Finocchiaro, Thomas; Steinseifer, Ulrich

2016-10-01

One of the most critical components regarding the durability of the ReinHeart total artificial heart (TAH) is its biocompatible diaphragm, which separates the drive unit from the ventricles. Hence, a durability tester was designed to investigate its required 5-year lifetime. The aim of this study was to prove the validity of accelerated testing of the polyurethane diaphragm. The durability tester allows simultaneous testing of 12 diaphragms and mimics physiological conditions. To accelerate the time of testing, it operates with an increased speed at a frequency of 8 Hz. To prove the correctness of this acceleration, a servo-hydraulic testing machine was used to study the effect of different frequencies and their corresponding loads. Thereby the viscoelastic behavior of the polyurethane was investigated. Additionally, high-speed video measurements were performed. The force against frequency and the high-speed video measurements showed constant behavior. In the range of 1-10 Hz, the maximum resulting forces varied by 3%, and the diaphragm movement was identical. Frequencies below 10 Hz allow a valid statement of the diaphragm's mechanical durability. Viscoelasticity of the polyurethane in the considered frequency-range is negligible. The accelerated durability test is applicable to polyurethane diaphragms, and the results are applicable to TAH use. The reliability of the diaphragm for a lifetime of 5 years was found to be 80% with a confidence of 62%. Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Electrical Stimulation of Artificial Heart Muscle: A Look Into the Electrophysiologic and Genetic Implications.

PubMed

Mohamed, Mohamed A; Islas, Jose F; Schwartz, Robert J; Birla, Ravi K

Development of tissue-engineered hearts for treatment of myocardial infarction or biologic pacemakers has been hindered by the production of mostly arrhythmic or in-synergistic constructs. Electrical stimulation (ES) of these constructs has been shown to produce tissues with greater twitch force and better adrenergic response. To further our understanding of the mechanisms underlying the effect of ES, we fabricated a bioreactor capable of delivering continuous or intermittent waveforms of various types to multiple constructs simultaneously. In this study, we examined the effect of an intermittent biphasic square wave on our artificial heart muscle (AHM) composed of neonatal rat cardiac cells and fibrin gel. Twitch forces, spontaneous contraction rates, biopotentials, gene expression profiles, and histologic observations were examined for the ES protocol over a 12 day culture period. We demonstrate improved consistency between samples for twitch force and contraction rate, and higher normalized twitch force amplitudes for electrically stimulated AHMs. Improvements in electrophysiology within the AHM were noted by higher conduction velocities and lower latency in electrical response for electrically stimulated AHMs. Genes expressing key electrophysiologic and structural markers peaked at days 6 and 8 of culture, only a few days after the initiation of ES. These results may be used for optimization strategies to establish protocols for producing AHMs capable of replacing damaged heart tissue in either a contractile or electrophysiologic capacity. Optimized AHMs can lead to alternative treatments to heart failure and alleviate the limited donor supply crisis.

Electrical Stimulation of Artificial Heart Muscle: a look into the electrophysiological and genetic implications

PubMed Central

Mohamed, Mohamed A; Islas, Jose F; Schwartz, Robert J; Birla, Ravi K

2016-01-01

Development of tissue-engineered hearts for treatment of myocardial infarction or biological pacemakers has been hindered by the production of mostly arrhythmic or in-synergistic constructs. Electrical stimulation (ES) of these constructs has been shown to produce tissues with greater twitch force and better adrenergic response. In order to further our understanding of the mechanisms underlying the effect of ES, we fabricated a bioreactor capable of delivering continuous or intermittent waveforms of various types to multiple constructs simultaneously. In this study, we examined the effect of an intermittent biphasic square wave on our artificial heart muscle (AHM) composed of neonatal rat cardiac cells and fibrin gel. Twitch forces, spontaneous contraction rates, biopotentials, gene expression profiles, and histological observations were examined for the ES protocol over a 12 day culture period. We demonstrate improved consistency between samples for twitch force and contraction rate, and higher normalized twitch force amplitudes for electrically stimulated AHM. Improvements in electrophysiology within the AHM was noted by higher conduction velocities and lower latency in electrical response for electrically stimulated AHM. Genes expressing key electrophysiological and structural markers peaked at days 6 and 8 of culture, only a few days after the initiation of ES. These results may be used for optimization strategies to establish protocols for producing AHM capable of replacing damaged heart tissue in either a contractile or electrophysiological capacity. Optimized AHM can lead to alternative treatments to heart failure and alleviate the limited donor supply crisis. PMID:28459744

Acute effects of a sarin-like organophosphorus agent, bis(isopropyl methyl)phosphonate, on cardiovascular parameters in anaesthetized, artificially ventilated rats

DOE Office of Scientific and Technical Information (OSTI.GOV)

Watanabe, Yoshimasa; Itoh, Takeo, E-mail: titoh@med.nagoya-cu.ac.jp; Shiraishi, Hiroaki

The organophosphorus compound sarin irreversibly inhibits acetylcholinesterase. We examined the acute cardiovascular effects of a sarin-like organophosphorus agent, bis(isopropyl methyl)phosphonate (BIMP), in anaesthetized, artificially ventilated rats. Intravenous administration of BIMP (0.8 mg/kg; the LD50 value) induced a long-lasting increase in blood pressure and tended to increase heart rate. In rats pretreated with the non-selective muscarinic-receptor antagonist atropine, BIMP significantly increased both heart rate and blood pressure. In atropine-treated rats, hexamethonium (antagonist of ganglionic nicotinic receptors) greatly attenuated the BIMP-induced increase in blood pressure without changing the BIMP-induced increase in heart rate. In rats treated with atropine plus hexamethonium, intravenous phentolaminemore » (non-selective α-adrenergic receptor antagonist) plus propranolol (non-selective β-adrenergic receptor antagonist) completely blocked the BIMP-induced increases in blood pressure and heart rate. In atropine-treated rats, the reversible acetylcholinesterase inhibitor neostigmine (1 mg/kg) induced a transient increase in blood pressure, but had no effect on heart rate. These results suggest that in anaesthetized rats, BIMP induces powerful stimulation of sympathetic as well as parasympathetic nerves and thereby modulates heart rate and blood pressure. They may also indicate that an action independent of acetylcholinesterase inhibition contributes to the acute cardiovascular responses induced by BIMP. - Highlights: • A sarin-like agent BIMP markedly increased blood pressure in anaesthetized rats. • Muscarinic receptor blockade enhanced the BIMP-induced increase in blood pressure. • Ganglionic nicotinic receptor blockade attenuated the BIMP-induced response. • Blockade of α- as well as β-receptors attenuated the BIMP-induced response.« less

A bioprosthetic total artificial heart for end-stage heart failure: Results from a pilot study.

PubMed

Latrémouille, Christian; Carpentier, Alain; Leprince, Pascal; Roussel, Jean-Christian; Cholley, Bernard; Boissier, Elodie; Epailly, Eric; Capel, Antoine; Jansen, Piet; Smadja, David M

2018-01-01

The electro-hydraulically actuated Carmat total artificial heart (C-TAH) is designed to replace the heart in patients with end-stage heart failure, either as bridge to transplant or destination therapy. It provides pulsatile flow and contains bio-prosthetic blood contacting materials. A clinical feasibility study was conducted to evaluate the C-TAH safety and performance. Hospitalized patients, at imminent risk of death from irreversible biventricular failure despite optimal medical management, and not eligible for transplant or eligible but on extracorporeal life support, were enrolled. The primary endpoint was 30-days survival. Four patients were implanted with the C-TAH, three as destination therapy (ages 76, 68, 74) and one as bridge to transplant (age 58). They had implant times of 74, 270, 254 and 20 days respectively. All patients were free from hemolysis, clinical neurologic events, clinical evidence of thrombus and device-related infections. Hemodynamic and physical recovery allowed two patients to be discharged home for a cumulative duration of 7 months. The anticoagulation management strategy comprised initial unfractionated heparin, from postoperative day 2, followed by low molecular weight heparin and aspirin. An increased D-dimer level was observed in all patients during months 1 to 4. Temporary suspension of heparin anticoagulation resulted in thrombocytopenia and increased fibrin monomer, reversed by resuming anticoagulation with heparin. Causes of death were device-related (2 cases), respiratory failure and multi-organ failure. Preliminary clinical results with the C-TAH demonstrated good safety and performance profiles in patients suffering from biventricular failure, which need to be confirmed in a pivotal study. Copyright © 2018 International Society for the Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Deairing Techniques for Double-Ended Centrifugal Total Artificial Heart Implantation.

PubMed

Karimov, Jamshid H; Horvath, David J; Byram, Nicole; Sunagawa, Gengo; Grady, Patrick; Sinkewich, Martin; Moazami, Nader; Sale, Shiva; Golding, Leonard A R; Fukamachi, Kiyotaka

2017-06-01

The unique device architecture of the Cleveland Clinic continuous-flow total artificial heart (CFTAH) requires dedicated and specific air-removal techniques during device implantation in vivo. These procedures comprise special surgical techniques and intraoperative manipulations, as well as engineering design changes and optimizations to the device itself. The current study evaluated the optimal air-removal techniques during the Cleveland Clinic double-ended centrifugal CFTAH in vivo implants (n = 17). Techniques and pump design iterations consisted of developing a priming method for the device and the use of built-in deairing ports in the early cases (n = 5). In the remaining cases (n = 12), deairing ports were not used. Dedicated air-removal ports were not considered an essential design requirement, and such ports may represent an additional risk for pump thrombosis. Careful passive deairing was found to be an effective measure with a centrifugal pump of this design. In this report, the techniques and design changes that were made during this CFTAH development program to enable effective residual air removal and prevention of air embolism during in vivo device implantation are explained. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Mind-wandering and alterations to default mode network connectivity when listening to naturalistic versus artificial sounds.

PubMed

Gould van Praag, Cassandra D; Garfinkel, Sarah N; Sparasci, Oliver; Mees, Alex; Philippides, Andrew O; Ware, Mark; Ottaviani, Cristina; Critchley, Hugo D

2017-03-27

Naturalistic environments have been demonstrated to promote relaxation and wellbeing. We assess opposing theoretical accounts for these effects through investigation of autonomic arousal and alterations of activation and functional connectivity within the default mode network (DMN) of the brain while participants listened to sounds from artificial and natural environments. We found no evidence for increased DMN activity in the naturalistic compared to artificial or control condition, however, seed based functional connectivity showed a shift from anterior to posterior midline functional coupling in the naturalistic condition. These changes were accompanied by an increase in peak high frequency heart rate variability, indicating an increase in parasympathetic activity in the naturalistic condition in line with the Stress Recovery Theory of nature exposure. Changes in heart rate and the peak high frequency were correlated with baseline functional connectivity within the DMN and baseline parasympathetic tone respectively, highlighting the importance of individual neural and autonomic differences in the response to nature exposure. Our findings may help explain reported health benefits of exposure to natural environments, through identification of alterations to autonomic activity and functional coupling within the DMN when listening to naturalistic sounds.

Mind-wandering and alterations to default mode network connectivity when listening to naturalistic versus artificial sounds

PubMed Central

Gould van Praag, Cassandra D.; Garfinkel, Sarah N.; Sparasci, Oliver; Mees, Alex; Philippides, Andrew O.; Ware, Mark; Ottaviani, Cristina; Critchley, Hugo D.

2017-01-01

Naturalistic environments have been demonstrated to promote relaxation and wellbeing. We assess opposing theoretical accounts for these effects through investigation of autonomic arousal and alterations of activation and functional connectivity within the default mode network (DMN) of the brain while participants listened to sounds from artificial and natural environments. We found no evidence for increased DMN activity in the naturalistic compared to artificial or control condition, however, seed based functional connectivity showed a shift from anterior to posterior midline functional coupling in the naturalistic condition. These changes were accompanied by an increase in peak high frequency heart rate variability, indicating an increase in parasympathetic activity in the naturalistic condition in line with the Stress Recovery Theory of nature exposure. Changes in heart rate and the peak high frequency were correlated with baseline functional connectivity within the DMN and baseline parasympathetic tone respectively, highlighting the importance of individual neural and autonomic differences in the response to nature exposure. Our findings may help explain reported health benefits of exposure to natural environments, through identification of alterations to autonomic activity and functional coupling within the DMN when listening to naturalistic sounds. PMID:28345604

Optimizing the tensile properties of polyvinyl alcohol hydrogel for the construction of a bioprosthetic heart valve stent.

PubMed

Wan, W K; Campbell, G; Zhang, Z F; Hui, A J; Boughner, D R

2002-01-01

Although bioprosthetic heart valves offer the benefits of a natural opening and closing, better hemodynamics, and avoidance of life-long anticoagulant therapy, they nevertheless tend to fail in 10-15 years from tears and calcification. Several authors, including the present ones, have identified the rigid stent as a factor contributing to these failures. The ultimate solution is an artificial heart valve that has mechanical properties that allow it to move in conformity with the aortic root during the cardiac cycle, has superior hemodynamics, is nonthrombogenic, will last more than 20 years, and mitigates the need for anticoagulants. We have identified a polymer, polyvinyl alcohol (PVA) hydrogel, that has mechanical properties similar to soft tissue. The purpose of this research is to match the tensile properties of PVA to the porcine aortic root and to fabricate a stent prototype for a bioprosthetic heart valve with the use of the PVA hydrogel. Specimens of 15% w/w PVA were prepared by processing through 1-6 cycles of freezing (-20 degrees C) at 0.2 degrees C/min freeze rate and thawing (+20 degrees C) at different thawing rates (0.2 degrees C/min and 1 degrees C/min), for different holding times (1 and 6 h) at -20 degrees C. Subsequently tensile tests and stress-relaxation tests were conducted on the specimens. The different holding times at -20 degrees C demonstrated no difference in the result. The slower thawing rate improved the tensile properties but did not produce significant changes on the stress-relaxation properties. The nonlinear stress-strain curve for the PVA after the fourth freeze-thaw cycle matched the porcine aortic root within the physiological pressure range. The stress-relaxation curve for PVA also approximated the shape of the aortic root. The complex geometry of an artificial heart valve stent was successfully injection molded. These results, in combination with other preliminary findings for biocompatibility and fatigue behavior, suggest that PVA hydrogel is a promising biomaterial for implants, catheters, and artificial skin. Copyright 2002 Wiley Periodicals, Inc.

78 FR 38867 - Gastroenterology-Urology Devices; Reclassification of Implanted Blood Access Devices

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-28

... artificial kidney system for the treatment of patients with renal failure or toxemic conditions and provides... into the heart or blood vessel could damage tissues and result in injuries. Hemolysis. Turbulence or...

High reliability linear drive device for artificial hearts

NASA Astrophysics Data System (ADS)

Ji, Jinghua; Zhao, Wenxiang; Liu, Guohai; Shen, Yue; Wang, Fangqun

2012-04-01

In this paper, a new high reliability linear drive device, termed as stator-permanent-magnet tubular oscillating actuator (SPM-TOA), is proposed for artificial hearts (AHs). The key is to incorporate the concept of two independent phases into this linear AH device, hence achieving high reliability operation. The fault-tolerant teeth are employed to provide the desired decoupling phases in magnetic circuit. Also, as the magnets and the coils are located in the stator, the proposed SPM-TOA takes the definite advantages of robust mover and direct-drive capability. By using the time-stepping finite element method, the electromagnetic characteristics of the proposed SPM-TOA are analyzed, including magnetic field distributions, flux linkages, back- electromotive forces (back-EMFs) self- and mutual inductances, as well as cogging and thrust forces. The results confirm that the proposed SPM-TOA meets the dimension, weight, and force requirements of the AH drive device.

Incompressible viscous flow computations for the pump components and the artificial heart

NASA Technical Reports Server (NTRS)

Kiris, Cetin

1992-01-01

A finite-difference, three-dimensional incompressible Navier-Stokes formulation to calculate the flow through turbopump components is utilized. The solution method is based on the pseudocompressibility approach and uses an implicit-upwind differencing scheme together with the Gauss-Seidel line relaxation method. Both steady and unsteady flow calculations can be performed using the current algorithm. In this work, the equations are solved in steadily rotating reference frames by using the steady-state formulation in order to simulate the flow through a turbopump inducer. Eddy viscosity is computed by using an algebraic mixing-length turbulence model. Numerical results are compared with experimental measurements and a good agreement is found between the two. Included in the appendix is a paper on incompressible viscous flow through artificial heart devices with moving boundaries. Time-accurate calculations, such as impeller and diffusor interaction, will be reported in future work.

BNP and congestive heart failure.

PubMed

Cowie, Martin R; Mendez, Gustavo F

2002-01-01

Brain natriuretic peptide (BNP), a peptide hormone secreted chiefly by ventricular myocytes, plays a key role in volume homeostasis. The plasma concentration of BNP is raised in various pathological states, especially heart failure. Many studies suggest that measurement of plasma BNP has clinical utility for excluding a diagnosis of heart failure in patients with dyspnea or fluid retention and for providing prognostic information in those with heart failure or other cardiac disease. It may also be of value in identifying patients after myocardial infarction in whom further assessment of cardiac function is likely to be worthwhile. Preliminary evidence suggests that measuring the plasma concentration of BNP may be useful in fine tuning therapy for heart failure. Artificially raising the circulating levels of BNP shows considerable promise as a treatment for heart failure. With simpler assay methods now available, it is likely that many physicians will measure plasma BNP to aid them in the diagnosis, risk stratification, and monitoring of their patients with heart failure or other cardiac dysfunction. Copyright 2002, Elsevier Science.

Time series data analysis using DFA

NASA Astrophysics Data System (ADS)

Okumoto, A.; Akiyama, T.; Sekino, H.; Sumi, T.

2014-02-01

Detrended fluctuation analysis (DFA) was originally developed for the evaluation of DNA sequence and interval for heart rate variability (HRV), but it is now used to obtain various biological information. In this study we perform DFA on artificially generated data where we already know the relationship between signal and the physical event causing the signal. We generate artificial data using molecular dynamics. The Brownian motion of a polymer under an external force is investigated. In order to generate artificial fluctuation in the physical properties, we introduce obstacle pillars fixed to nanostructures. Using different conditions such as presence or absence of obstacles, external field, and the polymer length, we perform DFA on energies and positions of the polymer.

Artificial intelligence in medicine: the challenges ahead.

PubMed

Coiera, E W

1996-01-01

The modern study of artificial intelligence in medicine (AIM) is 25 years old. Throughout this period, the field has attracted many of the best computer scientists, and their work represents a remarkable achievement. However, AIM has not been successful-if success is judged as making an impact on the practice of medicine. Much recent work in AIM has been focused inward, addressing problems that are at the crossroads of the parent disciplines of medicine and artificial intelligence. Now, AIM must move forward with the insights that it has gained and focus on finding solutions for problems at the heart of medical practice. The growing emphasis within medicine on evidence-based practice should provide the right environment for that change.

Translation of First North American 50 and 70 cc Total Artificial Heart Virtual and Clinical Implantations: Utility of 3D Computed Tomography to Test Fit Devices.

PubMed

Ferng, Alice S; Oliva, Isabel; Jokerst, Clinton; Avery, Ryan; Connell, Alana M; Tran, Phat L; Smith, Richard G; Khalpey, Zain

2017-08-01

Since the creation of SynCardia's 50 cc Total Artificial Hearts (TAHs), patients with irreversible biventricular failure now have two sizing options. Herein, a case series of three patients who have undergone successful 50 and 70 cc TAH implantation with complete closure of the chest cavity utilizing preoperative "virtual implantation" of different sized devices for surgical planning are presented. Computed tomography (CT) images were used for preoperative planning prior to TAH implantation. Three-dimensional (3D) reconstructions of preoperative chest CT images were generated and both 50 and 70 cc TAHs were virtually implanted into patients' thoracic cavities. During the simulation, the TAHs were projected over the native hearts in a similar position to the actual implantation, and the relationship between the devices and the atria, ventricles, chest wall, and diaphragm were assessed. The 3D reconstructed images and virtual modeling were used to simulate and determine for each patient if the 50 or 70 cc TAH would have a higher likelihood of successful implantation without complications. Subsequently, all three patients received clinical implants of the properly sized TAH based on virtual modeling, and their chest cavities were fully closed. This virtual implantation increases our confidence that the selected TAH will better fit within the thoracic cavity allowing for improved surgical outcome. Clinical implantation of the TAHs showed that our virtual modeling was an effective method for determining the correct fit and sizing of 50 and 70 cc TAHs. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Rapid Speed Modulation of a Rotary Total Artificial Heart Impeller.

PubMed

Kleinheyer, Matthias; Timms, Daniel L; Tansley, Geoffrey D; Nestler, Frank; Greatrex, Nicholas A; Frazier, O Howard; Cohn, William E

2016-09-01

Unlike the earlier reciprocating volume displacement-type pumps, rotary blood pumps (RBPs) typically operate at a constant rotational speed and produce continuous outflow. When RBP technology is used in constructing a total artificial heart (TAH), the pressure waveform that the TAH produces is flat, without the rise and fall associated with a normal arterial pulse. Several studies have suggested that pulseless circulation may impair microcirculatory perfusion and the autoregulatory response and may contribute to adverse events such as gastrointestinal bleeding, arteriovenous malformations, and pump thrombosis. It may therefore be beneficial to attempt to reproduce pulsatile output, similar to that generated by the native heart, by rapidly modulating the speed of an RBP impeller. The choice of an appropriate speed profile and control strategy to generate physiologic waveforms while minimizing power consumption and blood trauma becomes a challenge. In this study, pump operation modes with six different speed profiles using the BiVACOR TAH were evaluated in vitro. These modes were compared with respect to: hemodynamic pulsatility, which was quantified as surplus hemodynamic energy (SHE); maximum rate of change of pressure (dP/dt); pulse power index; and motor power consumption as a function of pulse pressure. The results showed that the evaluated variables underwent different trends in response to changes in the speed profile shape. The findings indicated a possible trade-off between SHE levels and flow rate pulsatility related to the relative systolic duration in the speed profile. Furthermore, none of the evaluated measures was sufficient to fully characterize hemodynamic pulsatility. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Viscosity-adjusted estimation of pressure head and pump flow with quasi-pulsatile modulation of rotary blood pump for a total artificial heart.

PubMed

Yurimoto, Terumi; Hara, Shintaro; Isoyama, Takashi; Saito, Itsuro; Ono, Toshiya; Abe, Yusuke

2016-09-01

Estimation of pressure and flow has been an important subject for developing implantable artificial hearts. To realize real-time viscosity-adjusted estimation of pressure head and pump flow for a total artificial heart, we propose the table estimation method with quasi-pulsatile modulation of rotary blood pump in which systolic high flow and diastolic low flow phased are generated. The table estimation method utilizes three kinds of tables: viscosity, pressure and flow tables. Viscosity is estimated from the characteristic that differential value in motor speed between systolic and diastolic phases varies depending on viscosity. Potential of this estimation method was investigated using mock circulation system. Glycerin solution diluted with salty water was used to adjust viscosity of fluid. In verification of this method using continuous flow data, fairly good estimation could be possible when differential pulse width modulation (PWM) value of the motor between systolic and diastolic phases was high. In estimation under quasi-pulsatile condition, inertia correction was provided and fairly good estimation was possible when the differential PWM value was high, which was not different from the verification results using continuous flow data. In the experiment of real-time estimation applying moving average method to the estimated viscosity, fair estimation could be possible when the differential PWM value was high, showing that real-time viscosity-adjusted estimation of pressure head and pump flow would be possible with this novel estimation method when the differential PWM value would be set high.

Memory beyond memory in heart beating, a sign of a healthy physiological condition.

PubMed

Allegrini, P; Grigolini, P; Hamilton, P; Palatella, L; Raffaelli, G

2002-04-01

We describe two types of memory and illustrate each using artificial and actual heartbeat data sets. The first type of memory, yielding anomalous diffusion, implies the inverse power-law nature of the waiting time distribution and the second the correlation among distinct times, and consequently also the occurrence of many pseudoevents, namely, not genuinely random events. Using the method of diffusion entropy analysis, we establish the scaling that would be determined by the real events alone. We prove that the heart beating of healthy patients reveals the existence of many more pseudoevents than in the patients with congestive heart failure.

Prediction of the external work of the native heart from the dynamic H-Q curves of the rotary blood pumps during left heart bypass.

PubMed

Yokoyama, Yoshimasa; Kawaguchi, Osamu; Kitao, Takashi; Kimura, Taro; Steinseifer, Ulrich; Takatani, Setsuo

2010-09-01

The ventricular performance is dependent on the drainage effect of rotary blood pumps (RBPs) and the performance of RBPs is affected by the ventricular pulsation. In this study, the interaction between the ventricle and RBPs was examined using the pressure-volume (P-V) diagram of the ventricle and dynamic head pressure-bypass flow (H-Q) curves (H, head pressure: arterial pressure minus ventricular pressure vs. Q, bypass flow) of the RBPs. We first investigated the relationships in a mock loop with a passive fill ventricle, followed by validation in ex vivo animal experiments. An apical drainage cannula with a micro-pressure sensor was especially fabricated to obtain ventricular pressure, while three pairs of ultrasonic crystals placed on the heart wall were used to derive ventricular volume. The mock loop-configured ventricular apical-descending aorta bypass revealed that the external work of the ventricle expressed by the area inside the P-V diagrams (EW(Heart) ) correlated strongly with the area inside dynamic H-Q curves (EW(VAD)), with the coefficients of correlation being R² = 0.869 ∼ 0.961. The results in the mock loop were verified in the ex vivo studies using three Shiba goats (10-25 kg in body weight), showing the correlation coefficients of R² = 0.802 ∼ 0.817. The linear regression analysis indicated that the increase in the bypass flow reduced pulsatility in the ventricle expressed in EW(Heart) as well as in EW(VAD) . Experimental results, both mock loop and animal studies, showed that the interaction between cardiac external work and H-Q performance of RBPs can be expressed by the relationships "EW(Heart) versus EW(VAD) ." The pulsatile nature of the native heart can be expressed in the area underneath the H-Q curves of RBPs EW(VAD) during left heart bypass indicating the status of the level of assistance by RBPs and the native heart function. © 2010, Copyright the Authors. Artificial Organs © 2010, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Sweetened Beverage Consumption, Incident Coronary Heart Disease and Biomarkers of Risk in Men

PubMed Central

de Koning, Lawrence; Malik, Vasanti S.; Kellogg, Mark D.; Rimm, Eric B.; Willett, Walter C.; Hu, Frank B.

2012-01-01

Background Sugar-sweetened beverage consumption is associated with weight gain and risk of type 2 diabetes. Few studies have tested for a relationship with coronary heart disease (CHD), or intermediate biomarkers. The role of artificially sweetened beverages is also unclear. Methods and Results We performed an analysis of the Health Professionals Follow-up study, a prospective cohort study including 42 883 men. Associations of cumulatively averaged sugar-sweetened (e.g. sodas) and artificially sweetened (e.g. diet sodas) beverage intake with incident fatal and non-fatal CHD (myocardial infarction) were examined using proportional hazard models. There were 3683 CHD cases over 22 years of follow-up. Participants in the top quartile of sugar-sweetened beverage intake had a 20% higher relative risk of CHD than those in the bottom quartile (RR=1.20, 95% CI: 1.09, 1.33, p for trend < 0.01) after adjusting for age, smoking, physical activity, alcohol, multivitamins, family history, diet quality, energy intake, BMI, pre-enrollment weight change and dieting. Artificially sweetened beverage consumption was not significantly associated with CHD (multivariate RR=1.02, 95% CI: 0.93, 1.12, p for trend = 0.28). Adjustment for self-reported high cholesterol, high triglycerides, high blood pressure and diagnosed type 2 diabetes slightly attenuated these associations. Intake of sugar-sweetened but not artificially sweetened beverages was significantly associated with increased triglycerides, CRP, IL6, TNFr1, TNFr2, decreased HDL, Lp(a), and leptin (p values < 0.02). Conclusions Consumption of sugar-sweetened beverages was associated with increased risk of CHD and some adverse changes in lipids, inflammatory factors, and leptin. Artificially sweetened beverage intake was not associated with CHD risk or biomarkers. PMID:22412070

A new transcutaneous bidirectional communication for monitoring implanted artificial heart using the human body as a conductive medium.

PubMed

Okamoto, Eiji; Kato, Yoshikuni; Seino, Kazuyuki; Miura, Hidekazu; Shiraishi, Yasuyuki; Yambe, Tomoyuki; Mitamura, Yoshinori

2012-10-01

A transcutaneous communication system (TCS) is a key technology for monitoring and controlling artificial hearts and other artificial organs in the body. In this study, we developed a new TCS that uses the human body as a conductive medium. Direct data exchange provides a higher level of communication security compared to that of wireless methods without physical constraints such as an external wire. The external and internal units of the new TCS each consist mainly of a data transmitter and a data receiver. The data transmitter has an amplitude shift keying (ASK) modulator (carrier frequencies: 4 and 10 MHz) and an electrode. The ASK-modulated data current is led into the body through the electrode, and it flows back to the energy source through the body, the data receiver, and the earth ground that includes all conductors and dielectrics in the environment that are in close proximity to the patient. Performance of the TCS was evaluated by a communication test on the surface of the human body and in an animal experiment using a goat. The TCS was able to transmit data concurrently for 4 weeks between everywhere on the surface of the body and everywhere inside the body under full-duplex communication at a transmission rate of 115 kbps. The power consumption of each TCS unit was 125 mW with an ASK-modulated current of 7 mA (root-mean-square). While further study is required to secure its safety, the newly developed TCS has promise to be a next-generation transcutaneous communication device. © 2012, Copyright the Authors. Artificial Organs © 2012, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Efficient physics-based tracking of heart surface motion for beating heart surgery robotic systems.

PubMed

Bogatyrenko, Evgeniya; Pompey, Pascal; Hanebeck, Uwe D

2011-05-01

Tracking of beating heart motion in a robotic surgery system is required for complex cardiovascular interventions. A heart surface motion tracking method is developed, including a stochastic physics-based heart surface model and an efficient reconstruction algorithm. The algorithm uses the constraints provided by the model that exploits the physical characteristics of the heart. The main advantage of the model is that it is more realistic than most standard heart models. Additionally, no explicit matching between the measurements and the model is required. The application of meshless methods significantly reduces the complexity of physics-based tracking. Based on the stochastic physical model of the heart surface, this approach considers the motion of the intervention area and is robust to occlusions and reflections. The tracking algorithm is evaluated in simulations and experiments on an artificial heart. Providing higher accuracy than the standard model-based methods, it successfully copes with occlusions and provides high performance even when all measurements are not available. Combining the physical and stochastic description of the heart surface motion ensures physically correct and accurate prediction. Automatic initialization of the physics-based cardiac motion tracking enables system evaluation in a clinical environment.

From Phonomecanocardiography to Phonocardiography computer aided

NASA Astrophysics Data System (ADS)

Granados, J.; Tavera, F.; López, G.; Velázquez, J. M.; Hernández, R. T.; López, G. A.

2017-01-01

Due to lack of training doctors to identify many of the disorders in the heart by conventional listening, it is necessary to add an objective and methodological analysis to support this technique. In order to obtain information of the performance of the heart to be able to diagnose heart disease through a simple, cost-effective procedure by means of a data acquisition system, we have obtained Phonocardiograms (PCG), which are images of the sounds emitted by the heart. A program of acoustic, visual and artificial vision recognition was elaborated to interpret them. Based on the results of previous research of cardiologists a code of interpretation of PCG and associated diseases was elaborated. Also a site, within the university campus, of experimental sampling of cardiac data was created. Phonocardiography computer-aided is a viable and low cost procedure which provides additional medical information to make a diagnosis of complex heart diseases. We show some previous results.

75 FR 6816 - Attorneys' Fees; Fee-Generating Cases; Use of Non-LSC Funds, Transfers of LSC Funds, Program...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-11

... heart regarding this restriction. Although Congress did not prohibit LSC from retaining the restriction... distinction to be artificial and not necessary to effectuate Congress' intention. LSC also believes that not...

An artificial molecular pump

NASA Astrophysics Data System (ADS)

Cheng, Chuyang; McGonigal, Paul R.; Schneebeli, Severin T.; Li, Hao; Vermeulen, Nicolaas A.; Ke, Chenfeng; Stoddart, J. Fraser

2015-06-01

Carrier proteins consume fuel in order to pump ions or molecules across cell membranes, creating concentration gradients. Their control over diffusion pathways, effected entirely through noncovalent bonding interactions, has inspired chemists to devise artificial systems that mimic their function. Here, we report a wholly artificial compound that acts on small molecules to create a gradient in their local concentration. It does so by using redox energy and precisely organized noncovalent bonding interactions to pump positively charged rings from solution and ensnare them around an oligomethylene chain, as part of a kinetically trapped entanglement. A redox-active viologen unit at the heart of a dumbbell-shaped molecular pump plays a dual role, first attracting and then repelling the rings during redox cycling, thereby enacting a flashing energy ratchet mechanism with a minimalistic design. Our artificial molecular pump performs work repetitively for two cycles of operation and drives rings away from equilibrium toward a higher local concentration.

Artificial intelligence in medicine: the challenges ahead.

PubMed Central

Coiera, E W

1996-01-01

The modern study of artificial intelligence in medicine (AIM) is 25 years old. Throughout this period, the field has attracted many of the best computer scientists, and their work represents a remarkable achievement. However, AIM has not been successful-if success is judged as making an impact on the practice of medicine. Much recent work in AIM has been focused inward, addressing problems that are at the crossroads of the parent disciplines of medicine and artificial intelligence. Now, AIM must move forward with the insights that it has gained and focus on finding solutions for problems at the heart of medical practice. The growing emphasis within medicine on evidence-based practice should provide the right environment for that change. PMID:8930853

Median Sternotomy or Right Thoracotomy Techniques for Total Artificial Heart Implantation in Calves.

PubMed

Karimov, Jamshid H; Moazami, Nader; Sunagawa, Gengo; Kobayashi, Mariko; Byram, Nicole; Sale, Shiva; Such, Kimberly A; Horvath, David J; Golding, Leonard A R; Fukamachi, Kiyotaka

2016-10-01

The choice of optimal operative access technique for mechanical circulatory support device implantation ensures successful postoperative outcomes. In this study, we retrospectively evaluated the median sternotomy and lateral thoracotomy incisions for placement of the Cleveland Clinic continuous-flow total artificial heart (CFTAH) in a bovine model. The CFTAH was implanted in 17 calves (Jersey calves; weight range, 77.0-93.9 kg) through a median sternotomy (n = 9) or right thoracotomy (n = 8) for elective chronic implantation periods of 14, 30, or 90 days. Similar preoperative preparation, surgical techniques, and postoperative care were employed. Implantation of the CFTAH was successfully performed in all cases. Both methods provided excellent surgical field visualization. After device connection, however, the median sternotomy approach provided better visualization of the anastomoses and surgical lines for hemostasis confirmation and repair due to easier device displacement, which is severely limited following right thoracotomy. All four animals sacrificed after completion of the planned durations (up to 90 days) were operated through full median sternotomy. Our data demonstrate that both approaches provide excellent initial field visualization. Full median sternotomy provides larger viewing angles at the anastomotic suture line after device connection to inflow and outflow ports. Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

75 FR 21506 - Fee-Generating Cases; Use of Non-LSC Funds, Transfers of LSC Funds, Program Integrity; Attorneys...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-26

... itself has had a change of heart regarding this restriction. Although Congress did not prohibit LSC from... performed. LSC continues to find such a distinction to be artificial and not necessary to effectuate...

Alignment of human cardiomyocytes on laser patterned biphasic core/shell nanowire assemblies

NASA Astrophysics Data System (ADS)

Kiefer, Karin; Lee, Juseok; Haidar, Ayman; Martinez Miró, Marina; Akkan, Cagri Kaan; Veith, Michael; Cenk Aktas, Oral; Abdul-Khaliq, Hashim

2014-12-01

The management of end stage heart failure patients is only possible by heart transplantation or by the implantation of artificial hearts as a bridge for later transplantation. However, these therapeutic strategies are limited by a lack of donor hearts and by the associated complications, such as coagulation and infection, due to the used artificial mechanical circulatory assist devices. Therefore, new strategies for myocardial regenerative approaches are under extensive research to produce contractile myocardial tissue in the future to replace non-contractile myocardial ischemic and scarred tissue. Different approaches, such as cell transplantation, have been studied intensively. Although successful approaches have been observed, there are still limitations to the application. It is envisaged that myocardial tissue engineering can be used to help replace infarcted non-contractile tissue. The developed tissue should later mimic the aligned fibrillar structure of the extracellular matrix and provide important guidance cues for the survival, function and the needed orientation of cardiomyocytes. Nanostructured surfaces have been tested to provide a guided direction that cells can follow. In the present study, the cellular adhesion/alignment of human cardiomyocytes and the biocompatibility have been investigated after cultivation on different laser-patterned nanowires compared with unmodified nanowires. As a result, the nanostructured surfaces possessed good biocompatibility before and after laser modification. The laser-induced scalability of the pattern enabled the growth and orientation of the adhered myocardial tissue. Such approaches may be used to modify the surface of potential scaffolds to develop myocardial contractile tissue in the future.

Ovalis TAH: development and in vitro testing of a new electromechanical energy converter for a total artificial heart.

PubMed

Sauer, I M; Frank, J; Spiegelberg, A; Bücherl, E S

2000-01-01

A new electromechanical energy converting system has been developed to yield an efficient and durable orthotopic total artificial heart (TAH). The energy converter we developed transforms the unidirectional rotational motion of the motor into a longitudinal forward-reverse movement of an internal geared oval, linked directly to pusher plates on both sides. To ensure a permanent positive connection between the drive gear and the internally geared wheel, a ball bearing runs inside an oval shaped guide track. Motor, gear unit, and conical pusher plates are seated between alternately ejecting and filling ventricles. The unidirectional motion of the brushless DC motor affords easier motor control, reduces energy demand, and ensures longer life of the motor when compared with a bidirectional motion system. In vitro testing has been performed on a mock circulation loop. The overall system efficiency of the TAH Ovalis was 27-39% (mean, 36%) for the pump output range of 2-7 L/min. The maximum output of 7 L/min can be obtained with a pump rate of 130 min(-1) and an afterload pressure of 140 mm Hg. For an average sized human with a mean cardiac output of 6 L/min at a mean aortic pressure of 120 mm Hg, 5 watts of input power would be required. The size of the prototype is 560 cm3, the weight is 950 g. Our first in vitro studies demonstrated the excellent efficiency and pump performance of this new electromechanical energy converter. The results prove the feasibility of this new concept's use as an energy converter for a total artificial heart.

Feasibility of a nickel-metal hydride battery for totally implantable artificial hearts.

PubMed

Okamoto, E; Yoshida, T; Fujiyoshi, M; Shimanaka, M; Takeuchi, A; Mitamura, Y; Mikami, T

1996-01-01

An implantable rechargeable battery is one of the key technologies for totally implantable artificial hearts. The nickel-metal hydride (Ni-MH) battery is promising for its high energy density of 1.5-2.0 times that of a nickel-cadmium battery. In this study, the effects of pulsatile discharge loads on the operating time and cycle life of Ni-MH batteries at 39 degrees C were studied. Two battery cells (TH-3M, 1,200 mAh, phi 14.5 x 49 mm; Toshiba, Tokyo, Japan) in series were charge/discharge cycled at 39 degrees C using a charge current of 1CA (1,200 mA) and then were fully discharged to 1.0 V/cell under either pulsatile discharge loads, which mimicked a systole (1 A for 0.3 sec) and a diastole (0.4 A for 0.3 sec), or a non pulsatile discharge load equivalent to the average of the pulsatile loads (0.7 A). Each cycle life test was interrupted on the 482nd cycle under pulsatile load, and on the 423rd cycle under non pulsatile load, because of malfunction of each battery charger. The tests showed that the pulsatile discharge cells had significantly (p < 0.001) less operating time (74.0 +/- 7.15 min) throughout the test period (up to 482 days) compared to the cells under equivalent non pulsatile discharge loads (93.7 +/- 7.74 min). The pulsatile-discharged Ni-MH cells provide significantly less operating time than the constantly discharged cells; the Ni-MH battery has an operating time of over 78 min and a cycle life of almost 500 cycles at 39 degrees C. In conclusion, the Ni-MH battery is feasible as an implantable back-up battery for a totally implantable artificial heart system.

Early in vivo experience with the pediatric continuous-flow total artificial heart.

PubMed

Karimov, Jamshid H; Horvath, David J; Byram, Nicole; Sunagawa, Gengo; Kuban, Barry D; Gao, Shengqiang; Dessoffy, Raymond; Fukamachi, Kiyotaka

2018-03-30

Heart transplantation in infants and children is an accepted therapy for end-stage heart failure, but donor organ availability is low and always uncertain. Mechanical circulatory support is another standard option, but there is a lack of intracorporeal devices due to size and functional range. The purpose of this study was to evaluate the in vivo performance of our initial prototype of a pediatric continuous-flow total artificial heart (P-CFTAH), comprising a dual pump with one motor and one rotating assembly, supported by a hydrodynamic bearing. In acute studies, the P-CFTAH was implanted in 4 lambs (average weight: 28.7 ± 2.3 kg) via a median sternotomy under cardiopulmonary bypass. Pulmonary and systemic pump performance parameters were recorded. The experiments showed good anatomical fit and easy implantation, with an average aortic cross-clamp time of 98 ± 18 minutes. Baseline hemodynamics were stable in all 4 animals (pump speed: 3.4 ± 0.2 krpm; pump flow: 2.1 ± 0.9 liters/min; power: 3.0 ± 0.8 W; arterial pressure: 68 ± 10 mm Hg; left and right atrial pressures: 6 ± 1 mm Hg, for both). Any differences between left and right atrial pressures were maintained within the intended limit of ±5 mm Hg over a wide range of ratios of systemic-to-pulmonary vascular resistance (0.7 to 12), with and without pump-speed modulation. Pump-speed modulation was successfully performed to create arterial pulsation. This initial P-CFTAH prototype met the proposed requirements for self-regulation, performance, and pulse modulation. Copyright © 2018 International Society for the Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

RIGHT VENTRICULAR UNLOADING AND RESPIRATORY SUPPORT WITH A WEARABLE ARTIFICIAL PUMP-LUNG (APL) IN AN OVINE MODEL

PubMed Central

Liu, Yang; Sanchez, Pablo G; Wei, Xufeng; Li, Tieluo; Watkins, Amelia C; Li, Shu-ying; Griffith, Bartley P; Wu, Zhongjun J

2014-01-01

Background Device availability of mechanical circulatory or respiratory support to the right heart has been limited. The purpose of this study was to investigate the effect of right heart unloading and respiratory support with a wearable integrated artificial pump-lung (APL). Methods The APL device was placed surgically between the right atrium and pulmonary artery in seven sheep. Anticoagulation was performed with heparin infusion. Its ability to unload the right ventricle (RV) was investigated by echocardiograms and right heart catheterization at different bypass flow rates. Hemodynamics and Echo data were evaluated. The device flow and gas transfer rates were also measured at different device speeds. Results Hemodynamics remained stable during APL support. There was no significant change in systemic blood pressure and cardiac index. Central venous pressure, RV pressure, RV end-diastolic dimension and RV ejection fraction were significant decreased when APL device flow rate approached 2 L/min. The linear regression showed significant correlative trends between the hemodynamic and cardiac indices and the device speed. The oxygen transfer rate increased with the device speed. The oxygen saturation from APL outlet was fully saturated (>95%) during the support. The impact of the APL support on blood elements (plasma free hemoglobin and platelet activation) was minimal. Conclusion The APL device support significantly unloaded the right ventricle with increasing device speed. The APL device provided stable hemodynamic and respiratory support in terms of blood flow and oxygen transfer. The right heart unloading performance of this wearable device need to be evaluated in the animal model with right heart failure for a long term support. PMID:24746636

Hemodynamics of a functional centrifugal-flow total artificial heart with functional atrial contraction in goats.

PubMed

Shiga, Takuya; Shiraishi, Yasuyuki; Sano, Kyosuke; Taira, Yasunori; Tsuboko, Yusuke; Yamada, Akihiro; Miura, Hidekazu; Katahira, Shintaro; Akiyama, Masatoshi; Saiki, Yoshikatsu; Yambe, Tomoyuki

2016-03-01

Implantation of a total artificial heart (TAH) is one of the therapeutic options for the treatment of patients with end-stage biventricular heart failure. There is no report on the hemodynamics of the functional centrifugal-flow TAH with functional atrial contraction (fCFTAH). We evaluated the effects of pulsatile flow by atrial contraction in acute animal models. The goats received fCFTAH that we created from two centrifugal-flow ventricular assist devices. Some hemodynamic parameters maintained acceptable levels: heart rate 115.5 ± 26.3 bpm, aortic pressure 83.5 ± 10.1 mmHg, left atrial pressure 18.0 ± 5.9 mmHg, pulmonary pressure 28.5 ± 9.7 mmHg, right atrial pressure 13.6 ± 5.2 mmHg, pump flow 4.0 ± 1.1 L/min (left) 3.9 ± 1.1 L/min (right), and cardiac index 2.13 ± 0.14 L/min/m(2). fCFTAH with atrial contraction was able to maintain the TAH circulation by forming a pulsatile flow in acute animal experiments. Taking the left and right flow rate balance using the low internal pressure loss of the VAD pumps may be easier than by other pumps having considerable internal pressure loss. We showed that the remnant atrial contraction effected the flow rate change of the centrifugal pump, and the atrial contraction waves reflected the heart rate. These results indicate that remnant atria had the possibility to preserve autonomic function in fCFTAH. We may control fCFTAH by reflecting the autonomic function, which is estimated with the flow rate change of the centrifugal pump.

Successful heart transplantation in patients with total artificial heart infections.

PubMed

Taimur, Sarah; Sullivan, Timothy; Rana, Mennakshi; Patel, Gopi; Roldan, Julie; Ashley, Kimberly; Pinney, Sean; Anyanwu, Anelechi; Huprikar, Shirish

2018-02-01

Data are limited on clinical outcomes in patients awaiting heart transplant (HT) with total artificial heart (TAH) infections. We retrospectively reviewed all TAH recipients at our center. TAH infection was classified as definite if a microorganism was isolated in cultures from the exit site or deep tissues around the TAH; as probable in patients without surgical or microbiologic evidence of infection but no other explanation for persistent or recurrent bloodstream infection (BSI); or possible in patients with clinical suspicion and radiographic findings suggestive of TAH infection, but without surgical intervention or microbiologic evidence. From 2012 to 2015, a total of 13 patients received a TAH, with a median age at implantation of 52 years (range: 28-60). TAH infection occurred in nine patients (seven definite, one probable, one possible) a median of 41 days after implant (range: 17-475). The majority of TAH infections were caused by Staphylococcus species. Seven of nine patients underwent HT (four had pre-HT mediastinal washout, and five had positive HT operative cultures). Three patients had an active BSI caused by the same pathogen causing TAH infection at the time of HT, with one developing a post-HT BSI with the same bacteria. No patient developed post-HT surgical site infection caused by the TAH infection pathogen. No deaths among HT recipients were attributed to infection. TAH infection is frequently associated with BSI and mediastinitis and Staphylococcus was the most common pathogen. A multimodal approach of appropriate pre- and post-HT antimicrobial therapy, surgical drainage, and heart transplantation with radical mediastinal debridement was successful in curing infection. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

9 CFR 312.2 - Official marks and devices to identify inspected and passed products of cattle, sheep, swine, or...

Code of Federal Regulations, 2010 CFR

2010-01-01

... livers, beef tongues, beef hearts, and smoked meats not in casings. EC11SE91.003 For application to... on shipping containers, band labels, artificial casings, and other articles with the approval of the...

Advances in material design for regenerative medicine, drug delivery and targeting/imaging

USDA-ARS?s Scientific Manuscript database

Many of the major breakthroughs and paradigm shifts in medicine to date have occurred due to innovations and materials and/or application/implementation of materials in clinical medicine. Artificial heart valves, implantable cardiac devices, limb prosthesis, cardiovascular stents, orthopedic implan...

Biofluid mechanics--an interdisciplinary research area of the future.

PubMed

Liepsch, Dieter

2006-01-01

Biofluid mechanics is a complex field that focuses on blood flow and the circulation. Clinical applications include bypass and anastomosis surgery, and the development of artificial heart valves and vessels, stents, vein and dialysis shunts. Biofluid mechanics is also involved in diagnostic and therapeutic measures, including CT and MRI, and ultrasound. The study of biofluid mechanics involves measuring blood flow, pressure, pulse wave, velocity distribution, the elasticity of the vessel wall, the flow behavior of blood to minimize complications in vessel,- neuro-, and heart surgery. Biofluid mechanics influence the lungs and circulatory system, the blood flow and micro-circulation; lymph flow, and artificial organs. Flow studies in arterial models can be done without invasive techniques on patients or animals. The results of fluid mechanic studies have shown that in the addition to basic biology, an understanding of the forces and movement on the cells is essential. Because biofluid mechanics allows for the detection of the smallest flow changes, it has an enormous potential for future cell research. Some of these will be discussed.

Power consumption of rotary blood pumps: pulsatile versus constant-speed mode.

PubMed

Pirbodaghi, Tohid; Cotter, Chris; Bourque, Kevin

2014-12-01

We investigated the power consumption of a HeartMate III rotary blood pump based on in vitro experiments performed in a cardiovascular simulator. To create artificial-pulse mode, we modulated the pump speed by decreasing the mean speed by 2000 rpm for 200 ms and then increasing speed by 4000 rpm (mean speeds plus 2000 rpm) for another 200 ms, creating a square waveform shape. The HeartMate III was connected to a cardiovascular simulator consisting of a hydraulic pump system to simulate left ventricle pumping action, arterial and venous compliance chambers, and an adjustable valve for peripheral resistance to facilitate the desired aortic pressure. The simulator operated based on Suga's elastance model to mimic the Starling response of the heart, thereby reproducing physiological blood flow and pressure conditions. We measured the instantaneous total electrical current and voltage of the pump to evaluate its power consumption. The aim was to answer these fundamental questions: (i) How does pump speed modulation affect pump power consumption? (ii) How does the power consumption vary in relation to external pulsatile flow? The results indicate that speed modulation and external pulsatile flow both moderately increase the power consumption. Increasing the pump speed reduces the impact of external pulsatile flow. Copyright © 2014 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Human Fitting Studies of Cleveland Clinic Continuous-Flow Total Artificial Heart

PubMed Central

Karimov, Jamshid H.; Steffen, Robert J.; Byram, Nicole; Sunagawa, Gengo; Horvath, David; Cruz, Vincent; Golding, Leonard A.R.; Fukamachi, Kiyotaka; Moazami, Nader

2015-01-01

Implantation of mechanical circulatory support devices is challenging, especially in patients with a small chest cavity. We evaluated how well the Cleveland Clinic continuous-flow total artificial heart (CFTAH) fit the anatomy of patients about to receive a heart transplant. A mock pump model of the CFTAH was rapid-prototyped using biocompatible materials. The model was brought to the operative table, and the direction, length, and angulation of the inflow/outflow ports and outflow conduits were evaluated after the recipient's ventricles had been resected. Thoracic cavity measurements were based on preoperative computed tomographic data. The CFTAH fit well in all five patients (height, 170 ± 9 cm; weight, 75 ± 24 kg). Body surface area was 1.9 ± 0.3 m2 (range, 1.6-2.1 m2). The required inflow and outflow port orientation of both the left and right housings appeared consistent with the current version of the CFTAH implanted in calves. The left outflow conduit remained straight, but the right outflow direction necessitated a 73 ± 22 degree angulation to prevent potential kinking when crossing over the connected left outflow. These data support the fact that our design achieves the proper anatomical relationship of the CFTAH to a patient's native vessels. PMID:25806613

Artificial sweeteners: a place in the field of functional foods? Focus on obesity and related metabolic disorders.

PubMed

Raben, Anne; Richelsen, Bjørn

2012-11-01

Artificial sweeteners can be a helpful tool to reduce energy intake and body weight and thereby risk for diabetes and cardiovascular diseases (CVD). Considering the prevailing diabesity (obesity and diabetes) epidemic, this can, therefore, be an important alternative to natural, calorie-containing sweeteners. The purpose of this review is to summarize the current evidence on the effect of artificial sweeteners on body weight, appetite, and risk markers for diabetes and CVD in humans. Short-term intervention studies have shown divergent results wrt appetite regulation, but overall artificial sweeteners cannot be claimed to affect hunger. Data from longer term intervention studies are scarce, but together they point toward a beneficial effect of artificial sweeteners on energy intake, body weight, liver fat, fasting and postprandial glycemia, insulinemia, and/or lipidemia compared with sugar. Epidemiological studies are not equivocal, but large cohort studies from the USA point toward decreased body weight and lower risk of type-2 diabetes and coronory heart diseases with increased intake of artificial sweeteners compared with sugar. Artificial sweeteners, especially in beverages, can be a useful aid to maintain reduced energy intake and body weight and decrease risk of type-2 diabetes and CVD compared with sugars. However, confirmative long-term intervention trials are still needed.

Measurement and reconstruction of the leaflet geometry for a pericardial artificial heart valve.

PubMed

Jiang, Hongjun; Campbell, Gord; Xi, Fengfeng

2005-03-01

This paper describes the measurement and reconstruction of the leaflet geometry for a pericardial heart valve. Tasks involved include mapping the leaflet geometries by laser digitizing and reconstructing the 3D freeform leaflet surface based on a laser scanned profile. The challenge is to design a prosthetic valve that maximizes the benefits offered to the recipient as compared to the normally operating naturally-occurring valve. This research was prompted by the fact that artificial heart valve bioprostheses do not provide long life durability comparable to the natural heart valve, together with the anticipated benefits associated with defining the valve geometries, especially the leaflet geometries for the bioprosthetic and human valves, in order to create a replicate valve fabricated from synthetic materials. Our method applies the concept of reverse engineering in order to reconstruct the freeform surface geometry. A Brown & Shape coordinate measuring machine (CMM) equipped with a HyMARC laser-digitizing system was used to measure the leaflet profiles of a Baxter Carpentier-Edwards pericardial heart valve. The computer software, Polyworks was used to pre-process the raw data obtained from the scanning, which included merging images, eliminating duplicate points, and adding interpolated points. Three methods, creating a mesh model from cloud points, creating a freeform surface from cloud points, and generating a freeform surface by B-splines are presented in this paper to reconstruct the freeform leaflet surface. The mesh model created using Polyworks can be used for rapid prototyping and visualization. To fit a freeform surface to cloud points is straightforward but the rendering of a smooth surface is usually unpredictable. A surface fitted by a group of B-splines fitted to cloud points was found to be much smoother. This method offers the possibility of manually adjusting the surface curvature, locally. However, the process is complex and requires additional manipulation. Finally, this paper presents a reverse engineered design for the pericardial heart valve which contains three identical leaflets with reconstructed geometry.

Total artificial heart in the pediatric patient with biventricular heart failure.

PubMed

Park, S S; Sanders, D B; Smith, B P; Ryan, J; Plasencia, J; Osborn, M B; Wellnitz, C M; Southard, R N; Pierce, C N; Arabia, F A; Lane, J; Frakes, D; Velez, D A; Pophal, S G; Nigro, J J

2014-01-01

Mechanical circulatory support emerged for the pediatric population in the late 1980s as a bridge to cardiac transplantation. The Total Artificial Heart (TAH-t) (SynCardia Systems Inc., Tuscon, AZ) has been approved for compassionate use by the Food and Drug Administration for patients with end-stage biventricular heart failure as a bridge to heart transplantation since 1985 and has had FDA approval since 2004. However, of the 1,061 patients placed on the TAH-t, only 21 (2%) were under the age 18. SynCardia Systems, Inc. recommends a minimum patient body surface area (BSA) of 1.7 m(2), thus, limiting pediatric application of this device. This unique case report shares this pediatric institution's first experience with the TAH-t. A 14-year-old male was admitted with dilated cardiomyopathy and severe biventricular heart failure. The patient rapidly decompensated, requiring extracorporeal life support. An echocardiogram revealed severe biventricular dysfunction and diffuse clot formation in the left ventricle and outflow tract. The decision was made to transition to biventricular assist device. The biventricular failure and clot formation helped guide the team to the TAH-t, in spite of a BSA (1.5 m(2)) below the recommendation of 1.7 m(2). A computed tomography (CT) scan of the thorax, in conjunction with a novel three-dimensional (3D) modeling system and team, assisted in determining appropriate fit. Chest CT and 3D modeling following implantation were utilized to determine all major vascular structures were unobstructed and the bronchi were open. The virtual 3D model confirmed appropriate device fit with no evidence of compression to the left pulmonary veins. The postoperative course was complicated by a left lung opacification. The left lung anomalies proved to be atelectasis and improved with aggressive recruitment maneuvers. The patient was supported for 11 days prior to transplantation. Chest CT and 3D modeling were crucial in assessing whether the device would fit, as well as postoperative complications in this smaller pediatric patient.

Attitude of the Saudi community towards heart donation, transplantation, and artificial hearts.

PubMed

AlHabeeb, Waleed; AlAyoubi, Fakhr; Tash, Adel; AlAhmari, Leenah; AlHabib, Khalid F

2017-07-01

To understand the attitudes of the Saudi population towards heart donation and transplantation. Methods: A survey using a questionnaire addressing attitudes towards organ transplantation and donation was conducted across 18 cities in Saudi Arabia between September 2015 and March 2016.  Results: A total of 1250 respondents participated in the survey. Of these, approximately 91% agree with the concept of organ transplantation but approximately 17% do not agree with the concept of heart transplantation; 42.4% of whom reject heart transplants for religious reasons. Only 43.6% of respondents expressed a willingness to donate their heart and approximately 58% would consent to the donation of a relative's organ after death. A total of 59.7% of respondents believe that organ donation is regulated and 31.8% fear that the doctors will not try hard enough to save their lives if they consent to organ donation. Approximately 77% believe the heart is removed while the donor is alive; although, the same proportion of respondents thought they knew what brain death meant. Conclusion: In general, the Saudi population seem to accept the concept of transplantation and are willing to donate, but still hold some reservations towards heart donation.

Minimal changes in heart rate of incubating American Oystercatchers (Haematopus palliatus) in response to human activity

USGS Publications Warehouse

Borneman, Tracy E.; Rose, Eli T.; Simons, Theodore R.

2014-01-01

An organism's heart rate is commonly used as an indicator of physiological stress due to environmental stimuli. We used heart rate to monitor the physiological response of American Oystercatchers (Haematopus palliatus) to human activity in their nesting environment. We placed artificial eggs with embedded microphones in 42 oystercatcher nests to record the heart rate of incubating oystercatchers continuously for up to 27 days. We used continuous video and audio recordings collected simultaneously at the nests to relate physiological response of birds (heart rate) to various types of human activity. We observed military and civilian aircraft, off-road vehicles, and pedestrians around nests. With the exception of high-speed, low-altitude military overflights, we found little evidence that oystercatcher heart rates were influenced by most types of human activity. The low-altitude flights were the only human activity to significantly increase average heart rates of incubating oystercatchers (12% above baseline). Although statistically significant, we do not consider the increase in heart rate during high-speed, low-altitude military overflights to be of biological significance. This noninvasive technique may be appropriate for other studies of stress in nesting birds.

Manufacturing Processes: New Methods for the "Materials Age." Resources in Technology.

ERIC Educational Resources Information Center

Technology Teacher, 1990

1990-01-01

To make the best use of new materials developed for everything from computers to artificial hearts to more fuel-efficient cars, improved materials syntheses and manufacturing processes are needed. This instructional module includes teacher materials, a student quiz, and possible student outcomes. (JOW)

Fluid mechanics of heart valves.

PubMed

Yoganathan, Ajit P; He, Zhaoming; Casey Jones, S

2004-01-01

Valvular heart disease is a life-threatening disease that afflicts millions of people worldwide and leads to approximately 250,000 valve repairs and/or replacements each year. Malfunction of a native valve impairs its efficient fluid mechanic/hemodynamic performance. Artificial heart valves have been used since 1960 to replace diseased native valves and have saved millions of lives. Unfortunately, despite four decades of use, these devices are less than ideal and lead to many complications. Many of these complications/problems are directly related to the fluid mechanics associated with the various mechanical and bioprosthetic valve designs. This review focuses on the state-of-the-art experimental and computational fluid mechanics of native and prosthetic heart valves in current clinical use. The fluid dynamic performance characteristics of caged-ball, tilting-disc, bileaflet mechanical valves and porcine and pericardial stented and nonstented bioprostheic valves are reviewed. Other issues related to heart valve performance, such as biomaterials, solid mechanics, tissue mechanics, and durability, are not addressed in this review.

Simulation of Blood flow in Different Configurations Design of Bi-leaflet Mechanical Heart Valve

NASA Astrophysics Data System (ADS)

Hafizah Mokhtar, N.; Abas, Aizat

2018-05-01

In this work, two different designs of artificial heart valve were devised and then compared by considering the thrombosis, wear and valve orifice to anatomical orifice ratio of each mechanical heart valve. These different design configurations of bi-leaflet mechanical heart valves model are created through the use of Computer-aided design (CAD) modelling and simulated using Computational fluid dynamic (CFD) software. Design 1 is based on existing conventional bi-leaflet valve and design 2 based on modified bi-leaflet respectively. The flow pattern, velocity, vorticity and stress analysis have been done to justify the best design. Based on results, both of the designs show a Doppler velocity index of less than the allowable standard of 2.2 which is safe to be used as replacement of the human heart valve. However, design 2 shows that it has a lower possibility of cavitation issue which will lead to lower thrombosis and provide good central flow area of blood as compared to design 1.

Fuzzy Expert System for Heart Attack Diagnosis

NASA Astrophysics Data System (ADS)

Hassan, Norlida; Arbaiy, Nureize; Shah, Noor Aziyan Ahmad; Afizah Afif@Afip, Zehan

2017-08-01

Heart attack is one of the serious illnesses and reported as the main killer disease. Early prevention is significant to reduce the risk of having the disease. The prevention efforts can be strengthen through awareness and education about risk factor and healthy lifestyle. Therefore the knowledge dissemination is needed to play role in order to distribute and educate public in health care management and disease prevention. Since the knowledge dissemination in medical is important, there is a need to develop a knowledge based system that can emulate human intelligence to assist decision making process. Thereby, this study utilized hybrid artificial intelligence (AI) techniques to develop a Fuzzy Expert System for Diagnosing Heart Attack Disease (HAD). This system integrates fuzzy logic with expert system, which helps the medical practitioner and people to predict the risk and as well as diagnosing heart attack based on given symptom. The development of HAD is expected not only providing expert knowledge but potentially become one of learning resources to help citizens to develop awareness about heart-healthy lifestyle.

Development and Evaluation of Heartbeat: A Machine Perfusion Heart Preservation System.

PubMed

Li, Yongnan; Zeng, Qingdong; Liu, Gang; Du, Junzhe; Gao, Bingren; Wang, Wei; Zheng, Zhe; Hu, Shengshou; Ji, Bingyang

2017-11-01

Static cold storage is accompanied with a partial safe ischemic interval for donor hearts. In this current study, a machine perfusion system was built to provide a better preservation for the donor heart and assessment for myocardial function. Chinese mini-swine (weight 30-35 kg, n = 16) were randomly divided into HTK, Celsior, and Heartbeat groups. All donor hearts were respectively preserved for 8 hours under static cold storage or machine perfusion. The perfusion solution is aimed to maintain its homeostasis based on monitoring the Heartbeat group. The ultrastructure of myocardium suggests better myocardial protection in the Heartbeat group compared with HTK or Celsior-preserved hearts. The myocardial and coronary artery structural and functional integrity was evaluated by immunofluorescence and Western blots in the Heartbeat. In the Heartbeat group, donor hearts maintained a high adenosine triphosphate level. Bcl-2 and Beclin-1 protein demonstrates high expression in the Celsior group. The Heartbeat system can be used to preserve donor hearts, and it could guarantee the myocardial and endothelial function of hearts during machine perfusion. Translating Heartbeat into clinical practice, it is such as to impact on donor heart preservation for cardiac transplantation. © 2017 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Power spectral analysis of R-R interval variability before and during the sinusoidal heart rate pattern in fetal lambs.

PubMed

Suzuki, T; Okamura, K; Kimura, Y; Watanabe, T; Yaegashi, N; Murotsuki, J; Uehara, S; Yajima, A

2000-05-01

The appearance of the sinusoidal heart rate pattern found on fetal cardiotocograms has not been fully explained, either physiologically or clinically. In this study we performed power spectral analysis on the sinusoidal heart rate pattern obtained by administration of arginine vasopressin and atropine sulfate to investigate its frequency components in fetal lambs with long-term instrument implantation. Eleven tests were performed in 4 fetal lambs at 120 to 130 days' gestation. An artificial sinusoidal heart rate pattern was obtained by administration of atropine sulfate and arginine vasopressin in 9 tests. An autoregression model was used to compare the spectral patterns before and during the sinusoidal heart rate pattern. Marked decreases in low-frequency (0.025-0.125 cycles/beat) and high-frequency (0.2-0.5 cycles/beat) areas were observed in the presence of the sinusoidal heart rate pattern. However, there were no significant changes in the very-low-frequency area (0.01-0.025 cycles/beat), which corresponds to the frequency of the sinusoidal heart rate pattern. The sinusoidal heart rate pattern may represent a very low-frequency component inherent in fetal heart rate variability that appears when low- and high-frequency components are reduced as a result of strongly suppressed autonomic nervous activity.

Artificial gait in complete spinal cord injured subjects: how to assess clinical performance.

PubMed

Pithon, Karla Rocha; Abreu, Daniela Cristina Carvalho de; Vasconcelos-Neto, Renata; Martins, Luiz Eduardo Barreto; Cliquet, Alberto

2015-02-01

Adapt the 6 minutes walking test (6MWT) to artificial gait in complete spinal cord injured (SCI) patients aided by neuromuscular electrical stimulation. Nine male individuals with paraplegia (AIS A) participated in this study. Lesion levels varied between T4 and T12 and time post injured from 4 to 13 years. Patients performed 6MWT 1 and 6MWT 2. They used neuromuscular electrical stimulation, and were aided by a walker. The differences between two 6MWT were assessed by using a paired t test. Multiple r-squared was also calculated. The 6MWT 1 and 6MWT 2 were not statistically different for heart rate, distance, mean speed and blood pressure. Multiple r-squared (r2 = 0.96) explained 96% of the variation in the distance walked. The use of 6MWT in artificial gait towards assessing exercise walking capacity is reproducible and easy to apply. It can be used to assess SCI artificial gait clinical performance.

Thermally induced magnetic relaxation in square artificial spin ice.

PubMed

Andersson, M S; Pappas, S D; Stopfel, H; Östman, E; Stein, A; Nordblad, P; Mathieu, R; Hjörvarsson, B; Kapaklis, V

2016-11-24

The properties of natural and artificial assemblies of interacting elements, ranging from Quarks to Galaxies, are at the heart of Physics. The collective response and dynamics of such assemblies are dictated by the intrinsic dynamical properties of the building blocks, the nature of their interactions and topological constraints. Here we report on the relaxation dynamics of the magnetization of artificial assemblies of mesoscopic spins. In our model nano-magnetic system - square artificial spin ice - we are able to control the geometrical arrangement and interaction strength between the magnetically interacting building blocks by means of nano-lithography. Using time resolved magnetometry we show that the relaxation process can be described using the Kohlrausch law and that the extracted temperature dependent relaxation times of the assemblies follow the Vogel-Fulcher law. The results provide insight into the relaxation dynamics of mesoscopic nano-magnetic model systems, with adjustable energy and time scales, and demonstrates that these can serve as an ideal playground for the studies of collective dynamics and relaxations.

Thermally induced magnetic relaxation in square artificial spin ice

NASA Astrophysics Data System (ADS)

Andersson, M. S.; Pappas, S. D.; Stopfel, H.; Östman, E.; Stein, A.; Nordblad, P.; Mathieu, R.; Hjörvarsson, B.; Kapaklis, V.

2016-11-01

The properties of natural and artificial assemblies of interacting elements, ranging from Quarks to Galaxies, are at the heart of Physics. The collective response and dynamics of such assemblies are dictated by the intrinsic dynamical properties of the building blocks, the nature of their interactions and topological constraints. Here we report on the relaxation dynamics of the magnetization of artificial assemblies of mesoscopic spins. In our model nano-magnetic system - square artificial spin ice - we are able to control the geometrical arrangement and interaction strength between the magnetically interacting building blocks by means of nano-lithography. Using time resolved magnetometry we show that the relaxation process can be described using the Kohlrausch law and that the extracted temperature dependent relaxation times of the assemblies follow the Vogel-Fulcher law. The results provide insight into the relaxation dynamics of mesoscopic nano-magnetic model systems, with adjustable energy and time scales, and demonstrates that these can serve as an ideal playground for the studies of collective dynamics and relaxations.

Heart Research

NASA Technical Reports Server (NTRS)

1991-01-01

James Antaki and a group of researchers from the University of Pittsburgh School of Medicine used many elements of the Technology Utilization Program while looking for a way to visualize and track material points within the heart muscle. What they needed were tiny artificial "eggs" containing copper sulfate solution, small enough (about 2 mm in diameter) that they would not injure the heart, and large enough to be seen in Magnetic Resonance Imaging (MRI) images; they also had to be biocompatible and tough enough to withstand the beating of the muscle. The group could not make nor buy sufficient containers. After reading an article on microspheres in NASA Tech Briefs, and a complete set of reports on microencapsulation from the Jet Propulsion Laboratory (JPL), JPL put Antaki in touch with Dr.Taylor Wang of Vanderbilt University who helped construct the myocardial markers. The research is expected to lead to improved understanding of how the heart works and what takes place when it fails.

From Life in a French Town to the Artificial Heart: An Approach to the Teaching of Scientific French.

ERIC Educational Resources Information Center

Ross, Margaret E.

1988-01-01

Describes the experiences of one instructor in designing and implementing a short course in scientific French for upper level students majoring in applied biology at Glasgow College. Materials used and aspects of scientific language chosen are briefly discussed. (LMO)

Cardiac and Vascular Function in Bedrested Volunteers: Effects of Artificial Gravity Training

NASA Technical Reports Server (NTRS)

Meng, M.; Platts, S.; Stenger, M.; Diedrich, A.; Schlegel, T.; Natapoff, A.; Knapp, C.; Evans, J.

2007-01-01

Cardiovascular effects of an artificial gravity (AG) countermeasure on deconditioned male volunteers were studied. In two groups of men we measured cardiovascular parameters at rest and in response to 30 minutes of 80 deg. head up tilt (HUT) before, at the end of, and four days following 21 days of 6 deg. head down bed rest (HDBR). One group (N=7) underwent no countermeasure while the other (N=8) received a daily, one hour, dose (2.5 gz at the foot, decreasing to 1.0 gz at the heart) of AG training on the Johnson Space Center short radius centrifuge. Cardiovascular parameters measured included heart rate, blood pressure, stroke volume, cardiac output, peripheral vascular resistance, plasma volume shifts, and vasoactive hormones. Untrained subjects exhibited shorter tilt survival (on average 8 minutes shorter) compared to trained subjects. By the end of bed rest, mean heart rate (MHR) was elevated in both groups (both supine and during tilt). In addition, treated subjects demonstrated lower, tilt-induced, increases in MHR four days following HDBR, indicating a more rapid return to pre bed rest conditions. Results from an index of autonomic balance (percentage of MHR spectral power in the respiratory frequency range) in control of heart rate are consistent with the interpretation that parasympathetic nervous system withdrawal was responsible for both tilt- and bed rest-induced increases in MHR. Our data support our pre-study hypothesis that AG treatment would lessen cardiovascular effects of deconditioning in bed rested men and suggest that AG should be further pursued as a space flight countermeasure.

Artificial organs versus regenerative medicine: is it true?

PubMed

Nosé, Yukihiko; Okubo, Hisashi

2003-09-01

Individuals engaged in the fields of artificial kidney and artificial heart have often mistakenly stated that "the era of artificial organs is over; regenerative medicine is the future." Contrarily, we do not believe artificial organs and regenerative medicine are different medical technologies. As a matter of fact, artificial organs developed during the last 50 years have been used as a bridge to regeneration. The only difference between regenerative medicine and artificial organs is that artificial organs for the bridge to regeneration promote tissue regeneration in situ, instead of outside the body (for example, vascular prostheses, neuroprostheses, bladder substitutes, skin prostheses, bone prostheses, cartilage prostheses, ligament prostheses, etc.). All of these artificial organs are successful because tissue regeneration over a man-made prosthesis is established inside the patient's body (artificial organs to support regeneration). Another usage of the group of artificial organs for the bridge to regeneration is to sustain the functions of the patient's diseased organs during the regeneration process of the body's healthy tissues and/or organs. This particular group includes artificial kidney, hepatic assist, respiratory assist, and circulatory assist. Proof of regeneration of these healthy tissues and/or organs is demonstrated in the short-term recovery of end-stage organ failure patients (artificial organs for bridge to regeneration). A third group of artificial organs for the bridge to regeneration accelerates the regenerating process of the patient's healthy tissues and organs. This group includes neurostimulators, artificial blood (red cells) blood oxygenators, and plasmapheresis devices, including hemodiafiltrators. So-called "therapeutic artificial organs" fall into this category (artificial organs to accelerate regeneration). Thus, almost all of today's artificial organs are useful in the bridge to regeneration of healthy natural tissues and organs. It does not matter whether these tissues are cultivated inside or outside the patient's body. Thus, we strongly believe in the need for joint development programs between artificial organ technologies and regenerative medicine technologies. In particular, the importance of using both man-made substitute organ technologies and natural tissue-derived substitute organ technologies is stressed for improved medical care in the future.

The effect of rigor mortis on the passage of erythrocytes and fluid through the myocardium of isolated dog hearts.

PubMed

Nevalainen, T J; Gavin, J B; Seelye, R N; Whitehouse, S; Donnell, M

1978-07-01

The effect of normal and artificially induced rigor mortis on the vascular passage of erythrocytes and fluid through isolated dog hearts was studied. Increased rigidity of 6-mm thick transmural sections through the centre of the posterior papillary muscle was used as an indication of rigor. The perfusibility of the myocardium was tested by injecting 10 ml of 1% sodium fluorescein in Hanks solution into the circumflex branch of the left coronary artery. In prerigor hearts (20 minute incubation) fluorescein perfused the myocardium evenly whether or not it was preceded by an injection of 10 ml of heparinized dog blood. Rigor mortis developed in all hearts after 90 minutes incubation or within 20 minutes of perfusing the heart with 50 ml of 5 mM iodoacetate in Hanks solution. Fluorescein injected into hearts in rigor did not enter the posterior papillary muscle and adjacent subendocardium whether or not it was preceded by heparinized blood. Thus the vascular occlusion caused by rigor in the dog heart appears to be so effective that it prevents flow into the subendocardium of small soluble ions such as fluorescein.

Artificial Respiration and Artificial Circulation

PubMed Central

Brook, Joseph; Brook, Morris H.; Lopez, Jose F.

1965-01-01

A training program in the newer methods of treatment of acute cardiopulmonary emergencies which was developed at the University Hospital, University of Saskatchewan, is reported. Artificial respiration by the chance rescuer, primary and secondary resuscitation, and post-resuscitation measures involving the use of special drugs and equipment by trained personnel are described. Figures and tables designed for wall-mounting and ready reference in an emergency situation are presented. Firstaid ventilatory adjuncts for use by trained personnel are classified and critically appraised, and the propriety of their use is emphasized. A plea is made to the medical profession and allied agencies to assume the responsibility of spreading knowledge of the new techniques more widely. Unless effective treatment is instituted early enough to prevent death or permanent anoxic damage to heart and brain, follow-through therapy will often be fruitless. PMID:14339303

Heart Pump Design for Cleveland Clinic Foundation

NASA Technical Reports Server (NTRS)

2005-01-01

Through a Lewis CommTech Program project with the Cleveland Clinic Foundation, the NASA Lewis Research Center is playing a key role in the design and development of a permanently implantable, artificial heart pump assist device. Known as the Innovative Ventricular Assist System (IVAS), this device will take on the pumping role of the damaged left ventricle of the heart. The key part of the IVAS is a nonpulsatile (continuous flow) artificial heart pump with centrifugal impeller blades, driven by an electric motor. Lewis is part of an industry and academia team, led by the Ohio Aerospace Institute (OAI), that is working with the Cleveland Clinic Foundation to make IVAS a reality. This device has the potential to save tens of thousands of lives each year, since 80 percent of heart attack victims suffer irreversible damage to the left ventricle, the part of the heart that does most of the pumping. Impeller blade design codes and flow-modeling analytical codes will be used in the project. These codes were developed at Lewis for the aerospace industry but will be applicable to the IVAS design project. The analytical codes, which currently simulate the flow through the compressor and pump systems, will be used to simulate the flow within the blood pump in the artificial heart assist device. The Interdisciplinary Technology Office heads up Lewis' efforts in the IVAS project. With the aid of numerical modeling, the blood pump will address many design issues, including some fluid-dynamic design considerations that are unique to the properties of blood. Some of the issues that will be addressed in the design process include hemolysis, deposition, recirculation, pump efficiency, rotor thrust balance, and bearing lubrication. Optimum pumping system performance will be achieved by modeling all the interactions between the pump components. The interactions can be multidisciplinary and, therefore, are influenced not only by the fluid dynamics of adjacent components but also by thermal and structural effects. Lewis-developed flow-modeling codes to be used in the pump simulations will include a one-dimensional code and an incompressible three-dimensional Navier-Stokes flow code. These codes will analyze the prototype pump designed by the Cleveland Clinic Foundation. With an improved understanding of the flow phenomena within the prototype pump, design changes to improve the performance of the pump system can be verified by computer prior to fabrication in order to reduce risks. The use of Lewis flow modeling codes during the design and development process will improve pump system performance and reduce the number of prototypes built in the development phase. The first phase of the IVAS project is to fully develop the prototype in a laboratory environment that uses a water/glycerin mixture as the surrogate fluid to simulate blood. A later phase of the project will include testing in animals for final validation. Lewis will be involved in the IVAS project for 3 to 5 years.

Veno-venous extracorporeal membrane oxygenation using a double-lumen bi-caval cannula for severe respiratory failure post total artificial heart implantation.

PubMed

Miessau, J; Yang, Q; Unai, S; Entwistle, J W C; Cavarocchi, N C; Hirose, H

2015-07-01

We report a unique utilization of a double-lumen, bi-caval Avalon cannula for veno-venous (VV) extracorporeal membrane oxygenation (ECMO) during placement of a total artificial heart (TAH, SynCardia, Tucson, AZ). A 22-year-old female with post-partum cardiomyopathy was rescued on veno-arterial (VA) ECMO because of cardiogenic shock. The inability to wean ECMO necessitated implantation of the TAH as a bridge to transplant. In addition, the patient continued to have respiratory failure and concomitant VV ECMO was planned with the implant. During TAH implantation, the Avalon cannula was placed percutaneously from the right internal jugular vein into the inferior vena cava (IVC) under direct vision while the right atrium was open. During VV ECMO support, adequate flows on both ECMO and TAH were maintained without adverse events. VV ECMO was discontinued, without reopening the chest, once the patient's respiratory failure improved. However, the patient subsequently developed a profound respiratory acidosis and required VV ECMO for CO2 removal. The Avalon cannula was placed in the femoral vein to avoid accessing the internal jugular vein and risking damage to the TAH. The patient's oxygenation eventually improved and the cannula was removed at the bedside. The patient was supported for 22 days on VV ECMO and successfully weaned from the ventilator prior to her orthotropic heart transplantation. © The Author(s) 2014.

Getting home with artifical heart – what is the everyday life experience of people with mechanical circulatory Support. A qualitative study

PubMed

Braunsdorf, Sandy

2017-07-01

Background: The growing number of mechanical circulatory support systems implanted with successful results in terms of quality of life and physical resilience means that more and more people are being discharged from hospital to live at home with an artificial heart. This puts high requirements on affected persons’ disease and therapy management – a subject which has attracted very little qualitative research to date. Aim: This study therefore sought to shed light on how people with mechanical circulatory support experience their everyday lives. The aim was to document the subjective associations of those affected from an insider perspective. Methods: Following the interpretative phenomenological paradigm, narrative interviews were conducted with two female and eight male participants. For qualitative analysis, a multi-step process guided by the methodology of hermeneutic philosophy was used. Results: The qualitative data analysis revealed five main topic areas. These describe patients’ state of health after implantation and the various adjustments, constraints and pressures necessitated by their illness and therapeutic requirements. On this basis, coping and management strategies are identified. Other significant aspects of patients’ everyday lives are social interaction and environment and health care with an artificial heart. Conclusions: The findings add to our knowledge of the day-to-day lives of people with mechanical circulatory support systems, giving us a better understanding of their specific situation.

Category Induction via Distributional Analysis: Evidence from a Serial Reaction Time Task

ERIC Educational Resources Information Center

Hunt, Ruskin H.; Aslin, Richard N.

2010-01-01

Category formation lies at the heart of a number of higher-order behaviors, including language. We assessed the ability of human adults to learn, from distributional information alone, categories embedded in a sequence of input stimuli using a serial reaction time task. Artificial grammars generated corpora of input strings containing a…

Capturing Problem-Solving Processes Using Critical Rationalism

ERIC Educational Resources Information Center

Chitpin, Stephanie; Simon, Marielle

2012-01-01

The examination of problem-solving processes continues to be a current research topic in education. Knowing how to solve problems is not only a key aspect of learning mathematics but is also at the heart of cognitive theories, linguistics, artificial intelligence, and computers sciences. Problem solving is a multistep, higher-order cognitive task…

Generating pulsatility by pump speed modulation with continuous-flow total artificial heart in awake calves.

PubMed

Fukamachi, Kiyotaka; Karimov, Jamshid H; Sunagawa, Gengo; Horvath, David J; Byram, Nicole; Kuban, Barry D; Dessoffy, Raymond; Sale, Shiva; Golding, Leonard A R; Moazami, Nader

2017-12-01

The purpose of this study was to evaluate the effects of sinusoidal pump speed modulation of the Cleveland Clinic continuous-flow total artificial heart (CFTAH) on hemodynamics and pump flow in an awake chronic calf model. The sinusoidal pump speed modulations, performed on the day of elective sacrifice, were set at ±15 and ± 25% of mean pump speed at 80 bpm in four awake calves with a CFTAH. The systemic and pulmonary arterial pulse pressures increased to 12.0 and 12.3 mmHg (±15% modulation) and to 15.9 and 15.7 mmHg (±25% modulation), respectively. The pulsatility index and surplus hemodynamic energy significantly increased, respectively, to 1.05 and 1346 ergs/cm at ±15% speed modulation and to 1.51 and 3381 ergs/cm at ±25% speed modulation. This study showed that it is feasible to generate pressure pulsatility with pump speed modulation; the platform is suitable for evaluating the physiologic impact of pulsatility and allows determination of the best speed modulations in terms of magnitude, frequency, and profiles.

Artificial heart development program. Volume I. System development. Phase III summary report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1977-01-01

The report documents efforts and results in the development of the power system portions of a calf implantable model of nuclear-powered artificial heart. The primary objective in developing the implantable model was to solve the packaging problems for total system implantation. The power systems portion is physically that portion of the implantable model between the Pu-238 heat sources and the blood pump ventricles. The work performed had two parallel themes. The first of these was the development of an integrated implantable model for bench and animal experiments plus design effort on a more advanced model. The second was research andmore » development on components of the system done in conjunction with the development of the implantable model and to provide technology for incorporation into advanced models plus support to implantations, at the University of Utah, of the systems blood pumping elements when driven by electric motor. The efforts and results of implantable model development are covered, mainly, in the text of the report. The research and development efforts and results are reported, primarily, in the appendices (Vol. 2).« less

The Syncardia™ total artificial heart: in vivo, in vitro, and computational modeling studies

PubMed Central

Slepian, Marvin J.; Alemu, Yared; Soares, João Silva; Smith, Richard G.; Einav, Shmuel; Bluestein, Danny

2014-01-01

The SynCardia™ total artificial heart (TAH) is the only FDA-approved TAH in the world. The SynCardia™ TAH is a pneumatically driven, pulsatile system capable of flows of >9 L/min. The TAH is indicated for use as a bridge to transplantation (BTT) in patients at imminent risk of death from non-reversible bi-ventricular failure. In the Pivotal US approval trial the TAH achieved a BTT rate of >79%. Recently a multi-center, post-market approval study similarly demonstrated a comparable BTT rate. A major milestone was recently achieved for the TAH, with over 1100 TAHs having been implanted to date, with the bulk of implantation occurring at an ever increasing rate in the past few years. The TAH is most commonly utilized to save the lives of patients dying from end-stage bi-ventricular heart failure associated with ischemic or non-ischemic dilated cardiomyopathy. Beyond progressive chronic heart failure, the TAH has demonstrated great efficacy in supporting patients with acute irreversible heart failure associated with massive acute myocardial infarction. In recent years several diverse clinical scenarios have also proven to be well served by the TAH including severe heart failure associated with advanced congenital heart disease. failed or burned-out transplants, infiltrative and restrictive cardiomyopathies and failed ventricular assist devices. Looking to the future a major unmet need remains in providing total heart support for children and small adults. As such, the present TAH design must be scaled to fit the smaller patient, while providing equivalent, if not superior flow characteristics, shear profiles and overall device thrombogenicity. To aid in the development of a new “pediatric,” TAH an engineering methodology known as “Device Thrombogenicity Emulation (DTE)”, that we have recently developed and described, is being employed. Recently, to further our engineering understanding of the TAH, as steps towards next generation designs we have: (1) assessed of the degree of platelet reactivity induced by the present clinical 70 cc TAH using a closed loop platelet activity state assay, (2) modeled the motion of the TAH pulsatile mobile diaphragm, and (3) performed fluid-structure interactions and assessment of the flow behavior through inflow and outflow regions of the TAH fitted with modern bi-leaflet heart valves. Developing a range of TAH devices will afford biventricular replacement therapy to a wide range of patients, for both short and long-term therapy. PMID:23305813

Oxygen and carbon dioxide transport in time-dependent blood flow past fiber rectangular arrays

NASA Astrophysics Data System (ADS)

Zierenberg, Jennifer R.; Fujioka, Hideki; Hirschl, Ronald B.; Bartlett, Robert H.; Grotberg, James B.

2009-03-01

The influence of time-dependent flows on oxygen and carbon dioxide transport for blood flow past fiber arrays arranged in in-line and staggered configurations was computationally investigated as a model for an artificial lung. Both a pulsatile flow, which mimics the flow leaving the right heart and passing through a compliance chamber before entering the artificial lung, and a right ventricular flow, which mimics flow leaving the right heart and directly entering the artificial lung, were considered in addition to a steady flow. The pulsatile flow was modeled as a sinusoidal perturbation superimposed on a steady flow while the right ventricular flow was modeled to accurately depict the period of flow acceleration (increasing flow) and deceleration (decreasing flow) during systole followed by zero flow during diastole. It was observed that the pulsatile flow yielded similar gas transport as compared to the steady flow, while the right ventricular flow resulted in smaller gas transport, with the decrease increasing with Re. The pressure drop across the fiber array (a measure of the resistance), work (an indicator of the work required of the right heart), and shear stress (a measure of potential blood cell activation and damage) are lowest for steady flow, followed by pulsatile flow, and then right ventricular flow. The pressure drop, work, shear stress, and Sherwood numbers (a measure of the gas transport efficiency) decrease with increasing porosity and are smaller for AR <1 as compared to AR >1 (AR is the distance between fibers in the flow direction/distance between fibers in direction perpendicular to flow), although for small porosities the Sherwood numbers are of similar magnitude. In general, for any fiber array geometry, high pressure drop, work, and shear stresses correlate with high Sherwood numbers, and low pressure drop, work, and shear stresses correlate with low Sherwood numbers creating a need for a compromise between pressure drop/work/shear stresses and gas transport.

Preliminary design of land displacement-optical fiber sensor and analysis of observation during laboratory and field test

NASA Astrophysics Data System (ADS)

Bayuwati, Dwi; Waluyo, Tomi B.; Widiyatmoko, Bambang

2015-01-01

An optical fiber optic sensor for detecting land displacement is discussed in this paper. The sensor system consists of a laser at wavelength 1.3 um, optical fiber coupler, optical fiber as sensor and light transmitting media, PIN photodiodedetector system, data logger and personal computer. Sensor was made from a curved optical fiber with diameter 35 mm, which will be changed into a heart-shape fiber if it is pulled. The heart-shape fiber sensor is the modification of the earlier displacement fiber sensor model which was in an ellipse form. Light to and from the optical fiber sensor was transmitted into a length of a multi core, single mode optical fiber cable. The scheme of the optical displacement sensor system has been described here. Characterization in the laboratory has been done by applying a series of pulling mechanism, on the heart-shape fiber sensor; which represents the land displacement process. Characterization in the field was carried out by mounting the sensor system on a scaled-down model of a land slope and artificially reproducing the landslide process using a steady-flow of artificial rainfall as the trigger. The voltage sensor output was recorded during the artificial landslide process. The displacement occurence can be indicated from the declining of the sensor signal received by the detector while the reference signal is steady. Characterization in the laboratory resulted in the performance of the optical fiber land displacement, namely, sensitivity 0.027(mV/mV)/mm, resolution 0.37 mm and measurement range 30 mm; compared with earlier optical fiber sensor performance with similar sensitivity and resolution which works only in 8 mm displacement range. Based on the experiment of landslides simulation in the field, we can define a critical condition in the real situation before landslides occurence to take any measures to prevent more casualties and losses.

Comparative analysis of von Willebrand factor profiles after implantation of left ventricular assist device and total artificial heart.

PubMed

Reich, H J; Morgan, J; Arabia, F; Czer, L; Moriguchi, J; Ramzy, D; Esmailian, F; Lam, L; Dunhill, J; Volod, O

2017-08-01

Essentials Bleeding is a major source of morbidity during mechanical circulatory support. von Willebrand factor (VWF) multimer loss may contribute to bleeding. Different patterns of VWF multimer loss were seen with the two device types. This is the first report of total artificial heart associated VWF multimer loss. Background Bleeding remains a challenge during mechanical circulatory support and underlying mechanisms are incompletely understood. Functional von Willebrand factor (VWF) impairment because of loss of high-molecular-weight multimers (MWMs) produces acquired von Willebrand disease (VWD) after left ventricular assist device (LVAD). Little is known about VWF multimers with total artificial hearts (TAHs). Here, VWF profiles with LVADs and TAHs are compared using a VWD panel. Methods VWD evaluations for patients with LVAD or TAH (2013-14) were retrospectively analyzed and included: VWF activity (ristocetin cofactor, VWF:RCo), VWF antigen (VWF:Ag), ratio of VWF:RCo to VWF:Ag, and quantitative VWF multimeric analysis. Results Twelve patients with LVADs and 12 with TAHs underwent VWD evaluation. All had either normal (47.8%) or elevated (52.2%) VWF:RCo, normal (26.1%) or elevated (73.9%) VWF:Ag and 50.0% were disproportional (ratio ≤ 0.7). Multimeric analysis showed abnormal patterns in all patients with LVADs: seven with high MWM loss; five with highest MWM loss. With TAH, 10/12 patients had abnormal patterns: all with highest MWM loss. High MWM loss correlated with presence of LVAD and highest MWM loss with TAH. Increased low MWMs were detected in 22/24. Conclusion Using VWF multimeric analysis, abnormalities after LVAD or TAH were detected that would be missed with measurements of VWF level alone: loss of high MWM predominantly in LVAD, loss of highest MWM in TAH, and elevated levels of low MWM in both. This is the first study to describe TAH-associated highest MWM loss, which may contribute to bleeding. © 2017 International Society on Thrombosis and Haemostasis.

[Resuscitation of vital activity after cold arrest of respiration by physiological methods without rewarming the body].

PubMed

Ivanov, K P

2014-01-01

The arrest of respiration during deep hypothermia means death, though at a low temperature the heart may rhythmically contract for 30-40 minutes more. The attempts of rewarming only shorten the time before the heart arrest. Calcium ions (Ca2+) are believed to accumulate in the nervous cells in cold. An excess of these ions inhibits the metabolism. Moreover it stimulates the cell proteases, which destroy the cell membranes. The aim of the study was to make the the attempts to develop the methods of stimulating the respiration and heart without rewarming the body. The work was carried out on wite rats 250-320g in weight. We introduced disodium salt of ethylenediaminetetraacetic acid into the animals. The second method of blocking the mechanisms of the cold death was artificial respiration. Ethylenediaminetetraacetic acid reacts with calcium ions, decreases their quantity in the blood, and, consequently, in a complex manner in the cell protoplasm. Artificial respiration not only increases the flow of oxygen into an organism but also decreases the lowest temperature threshold of the cold death of an organism. A decrease in the surviving threshold by 1.5-1.8 degrees C is very important from the point of view of reanimation of an organism since to preserve life in the critical period of reanimation each 0.5 degrees C are important. Prolongation of minimal frequency of heart contractions and maintaining a minimal arterial blood pressure in an overcooled organism given the body temperature of 11-12.5 degrees C is a special problem of great interest associated with many physiological and biological parameters.

Cardiovascular simulator improvement: pressure versus volume loop assessment.

PubMed

Fonseca, Jeison; Andrade, Aron; Nicolosi, Denys E C; Biscegli, José F; Leme, Juliana; Legendre, Daniel; Bock, Eduardo; Lucchi, Julio Cesar

2011-05-01

This article presents improvement on a physical cardiovascular simulator (PCS) system. Intraventricular pressure versus intraventricular volume (PxV) loop was obtained to evaluate performance of a pulsatile chamber mimicking the human left ventricle. PxV loop shows heart contractility and is normally used to evaluate heart performance. In many heart diseases, the stroke volume decreases because of low heart contractility. This pathological situation must be simulated by the PCS in order to evaluate the assistance provided by a ventricular assist device (VAD). The PCS system is automatically controlled by a computer and is an auxiliary tool for VAD control strategies development. This PCS system is according to a Windkessel model where lumped parameters are used for cardiovascular system analysis. Peripheral resistance, arteries compliance, and fluid inertance are simulated. The simulator has an actuator with a roller screw and brushless direct current motor, and the stroke volume is regulated by the actuator displacement. Internal pressure and volume measurements are monitored to obtain the PxV loop. Left chamber internal pressure is directly obtained by pressure transducer; however, internal volume has been obtained indirectly by using a linear variable differential transformer, which senses the diaphragm displacement. Correlations between the internal volume and diaphragm position are made. LabVIEW integrates these signals and shows the pressure versus internal volume loop. The results that have been obtained from the PCS system show PxV loops at different ventricle elastances, making possible the simulation of pathological situations. A preliminary test with a pulsatile VAD attached to PCS system was made. © 2011, Copyright the Authors. Artificial Organs © 2011, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Interagency registry for mechanically assisted circulatory support report on the total artificial heart.

PubMed

Arabía, Francisco A; Cantor, Ryan S; Koehl, Devin A; Kasirajan, Vigneshwar; Gregoric, Igor; Moriguchi, Jaime D; Esmailian, Fardad; Ramzy, Danny; Chung, Joshua S; Czer, Lawrence S; Kobashigawa, Jon A; Smith, Richard G; Kirklin, James K

2018-04-26

We sought to better understand the patient population who receive a temporary total artificial heart (TAH) as bridge to transplant or as bridge to decision by evaluating data from the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) database. We examined data related to survival, adverse events, and competing outcomes from patients who received TAHs between June 2006 and April 2017 and used hazard function analysis to explore risk factors for mortality. Data from 450 patients (87% men; mean age, 50 years) were available in the INTERMACS database. The 2 most common diagnoses were dilated cardiomyopathy (50%) and ischemic cardiomyopathy (20%). Risk factors for right heart failure were present in 82% of patients. Most patients were INTERMACS Profile 1 (43%) or 2 (37%) at implantation. There were 266 patients who eventually underwent transplantation, and 162 died. Overall 3-, 6-, and 12-month actuarial survival rates were 73%, 62%, and 53%, respectively. Risk factors for death included older age (p = 0.001), need for pre-implantation dialysis (p = 0.006), higher creatinine (p = 0.008) and lower albumin (p < 0.001) levels, and implantation at a low-volume center (≤10 TAHs; p < 0.001). Competing-outcomes analysis showed 71% of patients in high-volume centers were alive on the device or had undergone transplantation at 12 months after TAH implantation vs 57% in low-volume centers (p = 0.003). Patients receiving TAHs have rapidly declining cardiac function and require prompt intervention. Experienced centers have better outcomes, likely related to patient selection, timing of implantation, patient care, and device management. Organized transfer of knowledge to low-volume centers could improve outcomes. Copyright © 2018 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Tissue engineering and cell-based therapy toward integrated strategy with artificial organs.

PubMed

Gojo, Satoshi; Toyoda, Masashi; Umezawa, Akihiro

2011-09-01

Research in order that artificial organs can supplement or completely replace the functions of impaired or damaged tissues and internal organs has been underway for many years. The recent clinical development of implantable left ventricular assist devices has revolutionized the treatment of patients with heart failure. The emerging field of regenerative medicine, which uses human cells and tissues to regenerate internal organs, is now advancing from basic and clinical research to clinical application. In this review, we focus on the novel biomaterials, i.e., fusion protein, and approaches such as three-dimensional and whole-organ tissue engineering. We also compare induced pluripotent stem cells, directly reprogrammed cardiomyocytes, and somatic stem cells for cell source of future cell-based therapy. Integrated strategy of artificial organ and tissue engineering/regenerative medicine should give rise to a new era of medical treatment to organ failure.

Three-dimentional simulation of flow-induced platelet activation in artificial heart valves

NASA Astrophysics Data System (ADS)

Hedayat, Mohammadali; Asgharzadeh, Hafez; Borazjani, Iman

2015-11-01

Since the advent of heart valve, several valve types such as mechanical and bio-prosthetic valves have been designed. Mechanical Heart Valves (MHV) are durable but suffer from thromboembolic complications that caused by shear-induced platelet activation near the valve region. Bio-prosthetic Heart Valves (BHV) are known for better hemodynamics. However, they usually have a short average life time. Realistic simulations of heart valves in combination with platelet activation models can lead to a better understanding of the potential risk of thrombus formation in such devices. In this study, an Eulerian approach is developed to calculate the platelet activation in three-dimensional simulations of flow through MHV and BHV using a parallel overset-curvilinear immersed boundary technique. A curvilinear body-fitted grid is used for the flow simulation through the anatomic aorta, while the sharp-interface immersed boundary method is used for simulation of the Left Ventricle (LV) with prescribed motion. In addition, dynamics of valves were calculated numerically using under-relaxed strong-coupling algorithm. Finally, the platelet activation results for BMV and MHV are compared with each other.

Experimental study on the effect of an artificial cardiac valve on the left ventricular flow

NASA Astrophysics Data System (ADS)

Wang, JiangSheng; Gao, Qi; Wei, RunJie; Wang, JinJun

2017-09-01

The use of artificial valves to replace diseased human heart valves is currently the main solution to address the malfunctioning of these valves. However, the effect of artificial valves on the ventricular flow still needs to be understood in flow physics. The left ventricular flow downstream of a St. Jude Medical (SJM) bileaflet mechanical heart valve (BMHV), which is a widely implanted mechanical bileaflet valve, is investigated with time-resolved particle image velocimetry in the current work. A tilting-disk valve is installed on the aortic orifice to guarantee unidirectional flow. Several post-processing tools are applied to provide combined analyses of the physics involved in the ventricular flow. The triple jet pattern that is closely related to the characteristics of the bileaflet valve is discussed in detail from both Eulerian and Lagrangian views. The effects of large-scale vortices on the transportation of blood are revealed by the combined analysis of the tracking of Lagrangian coherent structures, the Eulerian monitoring of the shear stresses, and virtual dye visualization. It is found that the utilization of the SJM BMHV complicates the ventricular flow and could reduce the efficiency of blood transportation. In addition, the kinematics of the bileaflets is presented to explore the effects of flow structures on their motion. These combined analyses could elucidate the properties of SJM BMHV. Furthermore, they could provide new insights into the understanding of other complex blood flows.

Thermally induced magnetic relaxation in square artificial spin ice

DOE PAGES

Andersson, M. S.; Pappas, S. D.; Stopfel, H.; ...

2016-11-24

The properties of natural and artificial assemblies of interacting elements, ranging from Quarks to Galaxies, are at the heart of Physics. The collective response and dynamics of such assemblies are dictated by the intrinsic dynamical properties of the building blocks, the nature of their interactions and topological constraints. Here in this paper, we report on the relaxation dynamics of the magnetization of artificial assemblies of mesoscopic spins. In our model nano-magnetic system $-$ square artificial spin ice $-$ we are able to control the geometrical arrangement and interaction strength between the magnetically interacting building blocks by means of nano-lithography. Usingmore » time resolved magnetometry we show that the relaxation process can be described using the Kohlrausch law and that the extracted temperature dependent relaxation times of the assemblies follow the Vogel-Fulcher law. The results provide insight into the relaxation dynamics of mesoscopic nano-magnetic model systems, with adjustable energy and time scales, and demonstrates that these can serve as an ideal playground for the studies of collective dynamics and relaxations.« less

Thermally induced magnetic relaxation in square artificial spin ice

DOE Office of Scientific and Technical Information (OSTI.GOV)

Andersson, M. S.; Pappas, S. D.; Stopfel, H.

The properties of natural and artificial assemblies of interacting elements, ranging from Quarks to Galaxies, are at the heart of Physics. The collective response and dynamics of such assemblies are dictated by the intrinsic dynamical properties of the building blocks, the nature of their interactions and topological constraints. Here in this paper, we report on the relaxation dynamics of the magnetization of artificial assemblies of mesoscopic spins. In our model nano-magnetic system $-$ square artificial spin ice $-$ we are able to control the geometrical arrangement and interaction strength between the magnetically interacting building blocks by means of nano-lithography. Usingmore » time resolved magnetometry we show that the relaxation process can be described using the Kohlrausch law and that the extracted temperature dependent relaxation times of the assemblies follow the Vogel-Fulcher law. The results provide insight into the relaxation dynamics of mesoscopic nano-magnetic model systems, with adjustable energy and time scales, and demonstrates that these can serve as an ideal playground for the studies of collective dynamics and relaxations.« less

Effects of shade on physiological changes, oxidative stress, and total antioxidant power in Thai Brahman cattle.

PubMed

Aengwanich, Worapol; Kongbuntad, Watee; Boonsorn, Thongchai

2011-09-01

The purpose of this study was to assess the effects of artificial shade, tree shade, and no shade on physiological changes, oxidative stress, and total antioxidant power in Thai Brahman cattle. Twenty-one cattle were divided into three groups: cattle maintained under artificial shade, under tree shade, and without shade. On days 1, 7, 14, 21, and 28 of the experimental period, after the cattle were set in individual stalls for 2 h, physiological changes, thiobarbituric acid reactive substances (TBARS), and total antioxidant power were investigated. The results revealed that the respiratory rate, heart rate, sweat rate and the neutrophil/lymphocyte ratio of the no-shade cattle were significantly higher than those of cattle maintained under artificial shade and tree shade (P < 0.05). During the early period of heat exposure, the total antioxidant power of the no-shade cattle was lower than those of cattle maintained under artificial shade and tree shade, but the total antioxidant power of cattle maintained under artificial shade and tree shade were not different (P > 0.05). However, rectal temperature and packed cell volume of the cattle in all groups did not differ (P > 0.05). These results showed that artificial shade and tree shade can protect cattle from sunlight compared to no shade, and that the effectiveness of tree shade for sunlight protection is at an intermediate level.

Initial Evaluation of the Dermoskeleton Concept: Application of Biomechatronics and Artificial Intelligence to Address the Soldiers Overload Challenge

DTIC Science & Technology

2011-05-01

leg prosthesis for above-the-knee amputees currently commercialized by Ossur hf and developed by Victhom Human Bionics Inc., a medical device...did not feel they worked as hard when wearing the K-SRDTM version POC during the loaded conditions. However, based on our heart rate measured, there

Home Discharge and Out-of-Hospital Follow-Up of Total Artificial Heart Patients Supported by a Portable Driver System

PubMed Central

2014-01-01

To enhance ambulation and facilitate hospital discharge of total artificial heart (TAH)–supported patients, we adapted a mobile ventricular assistance device (VAD) driver (Excor) for TAH use and report on the performance of Excor-driven TAH patients discharged home. Ten patients stabilized on a TAH, driven by the CSS (“Circulatory Support System”), were progressively switched over to the Excor in hospital over 14 days as a pilot, with daily hemodynamics and laboratory parameters measured. Twenty-two stable TAH patients were subsequently placed on the Excor, trained, and discharged home. Clinical and hemodynamic parameters were followed. All pilot study patients were clinically stable on the Excor, with no decrease in TAH output noted (6.3 + 0.3 L/min [day 1] vs. 5.8 + 0.2 L/min [day 14], p = 0.174), with a trend suggesting improvement of both hepatic and renal function. Twenty-two TAH patients were subsequently successfully discharged home on the portable driver and were supported out of hospital for up to 598 days (range, 2–598; mean = 179 ± 140 days), remaining ambulatory, New York Heart Association (NYHA) class I or II, and free of readmission for 88.5% of the time of support. TAH patients may be effectively and safely supported by a mobile drive system. As such, the utility of the TAH may be extended to support patients beyond the hospital, at home, with overall ambulatory freedom. PMID:24577369

Comparison between artificial neural network and multilinear regression models in an evaluation of cognitive workload in a flight simulator.

PubMed

Hannula, Manne; Huttunen, Kerttu; Koskelo, Jukka; Laitinen, Tomi; Leino, Tuomo

2008-01-01

In this study, the performances of artificial neural network (ANN) analysis and multilinear regression (MLR) model-based estimation of heart rate were compared in an evaluation of individual cognitive workload. The data comprised electrocardiography (ECG) measurements and an evaluation of cognitive load that induces psychophysiological stress (PPS), collected from 14 interceptor fighter pilots during complex simulated F/A-18 Hornet air battles. In our data, the mean absolute error of the ANN estimate was 11.4 as a visual analog scale score, being 13-23% better than the mean absolute error of the MLR model in the estimation of cognitive workload.

Stevia, cyclamate and saccharin - natural and artificial sweeteners - exert no effect on sulfane levels in tissues.

PubMed

Wilinski, Bogdan; Opoka, Wlodzimierz; Somogyi, Eugeniusz; Piotrowska, Joanna; Wilinski, Jerzy

The interactions among natural and artificial sweeteners and endogenous sulfur metabolism have never been investigated. CBA strain mice were administered orally stevia, cyclamate or saccharin in doses of 5 mg/kg of body weight in water solutions each. The measurements of the free and acid-labile sulfane (H2S) tissue concentrations in brain, heart, liver and kidney were performed with Siegel spectrophotometric modified method. No differences in comparisons between hydrogen sulfide concentrations in the control group and each sweetener group within every tissue type were noted. In conclusion, stevia, cyclamate and saccharine do not change the endogenous sulfur metabolism to the extent of causing sulfane tissue levels alterations.

Fluid dynamics of heart assist device

NASA Technical Reports Server (NTRS)

Jones, R. T.

1976-01-01

Certain hemodynamic phenomena that arise in connection with the use of artificial blood pumping devices are reviewed. Among these are: (1) Flows produced by collapsing bulbs; (2) the impedance presented by the aorta; (3) limiting velocities and instability of flow in elastic vessels; (4) effectiveness of valveless arterio-arterial pumps, and (5) wave reflection phenomena and instabilities associated with the intra-aortic balloon pump.

Retrieval of an intra-cardiac embolised very long wire via transhepatic access from a war victim child.

PubMed

Baspinar, Osman; Sahin, Derya A; Yildirim, Ali

2016-04-01

We present the case report of a war victim child with severe burn scars, orthopnoea, and dyspnoea due to diffuse pulmonary thromboembolism. During ICU stay, a central venous catheter's 45-mm wire embolised into the heart. The embolised wire was successfully removed via transhepatic access through the creation of an artificial simple snare.

What a Decade of Experiments Reveals about Factors that Influence the Sense of Presence

DTIC Science & Technology

2006-03-01

Function HRV heart rate variability IBM International Business Machines Corporation ICAT International Conference on Artificial Intelligence and...Questionnaire. Person-related meas.: Social anxiety , age, gender, computer use. Task-related measures: Social anxiety assessment of partner. Performance...co-presence. (4) Computer use had a significant positive correlation with co-presence. (5) Participant’s social anxiety had a significant

Fracture and embolization of a Björk-Shiley disc. Fatal failure of a prosthetic mitral valve.

PubMed

Norenberg, D D; Evans, R W; Gundersen, A E; Abellera, R M

1977-12-01

A case of fracture of the disc occluder of a Bjork-Shiley mitral prosthesis with embolization of the disc fragments to distal aorta is presented. The possibility of valve dysfunction and the diagnostic value of echocardiography should be considered whenever acute heart failure occurs in a patient with an artificial valve.

Research Implications for Writing in the Content Areas. What Research Says to the Teacher. Second Edition.

ERIC Educational Resources Information Center

Yates, Joanne M.

The ideas of John Dewey and his fellow progressives have resurfaced in a movement called "writing across the curriculum." Interdisciplinary studies are now being seen as a way to break down the artificial boundaries between subject areas. Research has confirmed that language learning and experience are at the heart of education. The implications…

[Early activation of heart-operated patients as a tool for optimization of cardio-surgery curation (review)].

PubMed

2014-04-01

During last years in foreign countries there was widely introduced tactic of early activation of cardio-surgery patients. Necessary components of this methodical approach are early finishing of post-operation artificial respiration and extubation of trachea, shortening of time spending in intensive therapy till 1 day and sign out from stationary after 5 days. As a result of reducing hospitalization period, the curation costs are reduced significantly. Goal of this research was the analysis of methods of anesthesia that allow early extubation and activation after cardio-surgery interventions. There were analyzed data of protocols of anesthesia and post-operation periods for 270 patients. It was concluded that applied methods of anesthesia ensure adequate protection from operation stress and allow reduce time of post-operation artificial respiration, early activation of patients without reducing level of their safety. It was also proved that application of any type of anesthesia medicines is not influencing the temp of post-operation activation. Conducted research is proving the advisability of using tactic of early activation of patients after heart operations and considers this as a tool for optimization of cardio-surgery curation.

Electromagnetic Compatibility of Transcutaneous Energy Transmission Systemfor Totally Implantable Artificial Heart

NASA Astrophysics Data System (ADS)

Shiba, Kenji; Koshiji, Kohji

Transcutaneous Energy Transmission (TET) is one way of providing the energy needed to power a totally implantable artificial heart (TIAH). In the present study, an externally coupled TET system was implanted in a prototype human phantom to evaluate emission and immunity. In the emission evaluation, measurements were conducted based on CISPR Pub.11 and VDE 0871 standards, while immunity tests were based on the standards of the IEC 61000-4 series. The magnetic field of the radiated emission was measured using a loop antenna. At 0.1[MHz], we found the greatest magnetic field of 47.8 [dBμA/m], somewhat less than CISPR’s upper limit of 54 [dBμA/m]. For the conducted emission, by installing a noise filter and ferrite beads in the input section of the DC-power supply, conducted emission could be kept within the allowable limits of CISPR Pub.11 and VDE 0871. Finally, the immunity tests against radiated and conducted emission, electrostatic discharge and voltage fluctuation proved that the prototype could withstand the maximum level of disturbance. These results confirmed that the TET system implanted in a human phantom could, through modification, meet the emission and immunity standards.

Driver electronics design and control for a total artificial heart linear motor.

PubMed

Unthan, Kristin; Cuenca-Navalon, Elena; Pelletier, Benedikt; Finocchiaro, Thomas; Steinseifer, Ulrich

2018-01-27

For any implantable device size and efficiency are critical properties. Thus, a linear motor for a Total Artificial Heart was optimized with focus on driver electronics and control strategies. Hardware requirements were defined from power supply and motor setup. Four full bridges were chosen for the power electronics. Shunt resistors were set up for current measurement. Unipolar and bipolar switching for power electronics control were compared regarding current ripple and power losses. Here, unipolar switching showed smaller current ripple and required less power to create the necessary motor forces. Based on calculations for minimal power losses Lorentz force was distributed to the actor's four coils. The distribution was determined as ratio of effective magnetic flux through each coil, which was captured by a force test rig. Static and dynamic measurements under physiological conditions analyzed interaction of control and hardware and all efficiencies were over 89%. In conclusion, the designed electronics, optimized control strategy and applied current distribution create the required motor force and perform optimal under physiological conditions. The developed driver electronics and control offer optimized size and efficiency for any implantable or portable device with multiple independent motor coils. Graphical Abstract ᅟ.

Biocompatibility of Hydrogen-Diluted Amorphous Silicon Carbide Thin Films for Artificial Heart Valve Coating

NASA Astrophysics Data System (ADS)

Rizal, Umesh; Swain, Bhabani S.; Rameshbabu, N.; Swain, Bibhu P.

2018-01-01

Amorphous silicon carbide (a-SiC:H) thin films were synthesized using trichloromethylsilane by a hot wire chemical vapor deposition process. The deposited films were characterized by Fourier transform infrared spectroscopy (FTIR), Raman spectroscopy, x-ray diffraction and x-ray photoelectron spectroscopy to confirm its chemical bonding, structural network and composition of the a-SiC:H films. The optical microscopy images reveal that hydrogen dilution increased the surface roughness and pore density of a-SiC:H thin film. The Raman spectroscopy and FTIR spectra reveal chemical network consisting of Si-Si, C-C and Si-C bonds, respectively. The XRD spectroscopy and Raman spectroscopy indicate a-SiC:H still has short-range order. In addition, in vitro cytotoxicity test ensures the behavior of cell-semiconductor hybrid to monitor the proper coordination. The live-dead assays and MTT assay reveal an increase in green nucleus cell, and cell viability is greater than 88%, respectively, showing non-toxic nature of prepared a-SiC:H film. Moreover, the result indicated by direct contact assay, and cell prefers to adhere and proliferate on a-SiC:H thin films having a positive effect as artificial heart valve coating material.

Peripheral Artery Disease and Continuous Flow Left Ventricle Assist Device: An Engaging Complement Analysis May Help to Guide Treatment.

PubMed

Falletta, Calogero; Pasta, Salvatore; Raffa, Giuseppe Maria; Crinò, Francesca; Sciacca, Sergio; Clemenza, Francesco

2018-02-13

Use of continuous flow left ventricle assist device (CF-LVAD) in advanced heart failure (HF) patients results in clinically relevant improvements in survival, functional capacity, and quality of life. Peripheral artery disease (PAD) can occur in patients with CF-LVAD due to the high rate of concomitance between risk factors for atherosclerosis and HF. Diagnosis of PAD can be difficult in the specific setting of a patient supported by this kind of device because of the marked alteration in waveform morphology and velocity created by the artificial physiology of an LVAD. We report the case of a 53-year-old man with HF secondary to ischemic cardiomyopathy supported by the HeartWare HVAD as bridge to transplant, who after the implant developed symptoms suggestive of PAD. We describe additional computational flow analysis for the study of PAD-related hemodynamic disturbances induced by a CF-LVAD. Flow simulations enhance the information of clinical image data, and may have an application in clinical investigations of the risk of hemodynamic disturbances induced by LVAD implantation. © 2018 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

A case study of the New York City trans-fat story for international application.

PubMed

Tan, Andy S L

2009-04-01

Heart disease is the leading cause of death in New York City and contributes to significant burden of disease in the United States and internationally. Excessive intake of artificial trans-fatty acids has been causally associated with increased risk of heart disease. This article describes New York City's 2007 trans-fatty acids regulation, which was aimed at lowering the prevalence of heart disease among the city's residents by prohibiting the use of trans-fatty acids in the preparation of food in the city's food outlets. The author describes sequentially: (1) formulation, (2) public consultation, (3) implementation and (4) evaluation of the policy. He proposes a strategic framework for food policy development for international policymakers who are considering similar regulations. The framework includes four domains: (1) background research, (2) stakeholder support, (3) effective policy implementation and (4) evaluation and dissemination.

Frozen Plains in the Heart of Pluto Heart

NASA Image and Video Library

2015-07-17

At center left of Pluto vast heart-shaped feature "Tombaugh Regio" -- lies a vast, craterless plain that appears to be no more than 100 million years old, and is possibly still being shaped by geologic processes as seen by NASA New Horizons spacecraft. This frozen region is north of Pluto's icy mountains and has been informally named Sputnik Planum (Sputnik Plain), after Earth's first artificial satellite. The surface appears to be divided into irregularly-shaped segments that are ringed by narrow troughs. Features that appear to be groups of mounds and fields of small pits are also visible. This image was acquired by the Long Range Reconnaissance Imager (LORRI) on July 14 from a distance of 48,000 miles (77,000 kilometers). Features as small as one-half mile (1 kilometer) across are visible. The blocky appearance of some features is due to compression of the image. http://photojournal.jpl.nasa.gov/catalog/PIA19841

Influence of red jersey color on physical parameters in combat sports.

PubMed

Dreiskaemper, Dennis; Strauss, Bernd; Hagemann, Norbert; Büsch, Dirk

2013-02-01

Hill and Barton (2005) showed that fighters in tae kwon do, boxing, and wrestling who wore red jerseys during the 2004 Olympic Games won more often than those wearing blue jerseys. Regarding these results, this study investigated the effects of jersey color during a combat situation on fighters' physical parameters of strength and heart rate. An artificial, experimental combat situation was created in which the color of sport attire was assigned randomly. Fourteen pairs of male athletes matched for weight, height, and age had to fight each other: once in a red jersey and once in a blue. Heart rate (before, during, and after the fight) and strength (before the fight) were tested wearing the blue and the red jerseys. Participants wearing red jerseys had significantly higher heart rates and significantly higher pre-contest values on the strength test. Results showed that participants' body functions are influenced by wearing red equipment.

[Multi-channel data collection and visualization system for intramyocardial electrograms].

PubMed

Kastner, P; Wimmer, W; Hutten, H

2000-11-01

The aim of the project was to develop a multichannel data acquisition system for the recording and visualisation of intramyocardial electrograms (IEGM) from both the spontaneously beating and the artificially paced heart. Signal processing comprises multi-step amplification, filtering (0.05-800 Hz), and AD conversion (12 Bit max. 6.25 kHz). IEGMs can be obtained either in unipolar or bipolar mode. Stimulation of the heart is achieved by an incorporated programmable dual-chamber pacemaker that can be selectively switched to the input channels. A LabView-based graphical user interface permits the programming of all system parameters via a microcontroller, and supports data acquisition and visualisation. The system can be used in animal experiments to monitor the spread of excitation across the heart, to measure propagation velocity, or to measure the impact of drugs and pathological changes on the morphology of IEGMs.

Resource management in cardiovascular engineering: is outsourcing the solution?

PubMed

Feyrer, Richard; Weyand, Michael; Kunzmann, Udo

2005-09-01

In recent years, modern medicine has changed considerably. At maximum care centers, in particular, the use of state-of-the-art medical equipment has become an essential part of patient care. HoWever, using such high-tech products also means a considerable burden on the financial resources available, because additional financing is rare. Consequently, there is a need for approaches that allow the use of state-of-the-art equipment without straining the budget unduly. The question now is whether economic strategies that have long since been established in other industries, e.g., the outsourcing of certain services, represent a potential solution for the economic problems of modern clinics. The fundamentals of outsourcing and its pros and cons are outlined and discussed, taking cardiovascular perfusion as an example, a cost-intensive field of heart surgery that is responsible for attending to heart-lung machines, artificial hearts and circulatory support systems.

Detection of MRI artifacts produced by intrinsic heart motion using a saliency model

NASA Astrophysics Data System (ADS)

Salguero, Jennifer; Velasco, Nelson; Romero, Eduardo

2017-11-01

Cardiac Magnetic Resonance (CMR) requires synchronization with the ECG to correct many types of noise. However, the complex heart motion frequently produces displaced slices that have to be either ignored or manually corrected since the ECG correction is useless in this case. This work presents a novel methodology that detects the motion artifacts in CMR using a saliency method that highlights the region where the heart chambers are located. Once the Region of Interest (RoI) is set, its center of gravity is determined for the set of slices composing the volume. The deviation of the gravity center is an estimation of the coherence between the slices and is used to find out slices with certain displacement. Validation was performed with distorted real images where a slice is artificially misaligned with respect to set of slices. The displaced slice is found with a Recall of 84% and F Score of 68%.

Femtosecond laser-induced ripple patterns for homogenous nanostructuring of pyrolytic carbon heart valve implant

NASA Astrophysics Data System (ADS)

Stępak, Bogusz; Dzienny, Paulina; Franke, Volker; Kunicki, Piotr; Gotszalk, Teodor; Antończak, Arkadiusz

2018-04-01

Laser-induced periodic surface structures (LIPSS) are highly periodic wavy surface features which are frequently smaller than incident light wavelength that bring possibility of nanostructuring of many materials. In this paper the possibility of using them to homogeneously structure the surface of artificial heart valve made of PyC was examined. By changing laser irradiation parameters such like energy density and pulse separation the most suitable conditions were established for 1030 nm wavelength. A wide spectrum of periodicities and geometries was obtained. Interesting side effects like creating a thin shell-like layer were observed. Modified surfaces were examined using EDX and Raman spectroscopy to determine change in elemental composition of surface.

Enhancement in biological response of Ag-nano composite polymer membranes using plasma treatment for fabrication of efficient bio materials

NASA Astrophysics Data System (ADS)

Agrawal, Narendra Kumar; Sharma, Tamanna Kumari; Chauhan, Manish; Agarwal, Ravi; Vijay, Y. K.; Swami, K. C.

2016-05-01

Biomaterials are nonviable material used in medical devices, intended to interact with biological systems, which are becoming necessary for the development of artificial material for biological systems such as artificial skin diaphragm, valves for heart and kidney, lenses for eye etc. Polymers having novel properties like antibacterial, antimicrobial, high adhesion, blood compatibility and wettability are most suitable for synthesis of biomaterial, but all of these properties does not exist in any natural or artificial polymeric material. Nano particles and plasma treatment can offer these properties to the polymers. Hence a new nano-biomaterial has been developed by modifying the surface and chemical properties of Ag nanocomposite polymer membranes (NCPM) by Argon ion plasma treatment. These membranes were characterized using different techniques for surface and chemical modifications occurred. Bacterial adhesion and wettability were also tested for these membranes, to show direct use of this new class of nano-biomaterial for biomedical applications.

Design and construction of the artificial patient module for testing bioimpedance measuring devices

NASA Astrophysics Data System (ADS)

Młyńczak, Marcel; Pariaszewska, Katarzyna; Niewiadomski, Wiktor; Cybulski, Gerard

2013-10-01

The purpose of this study was to describe the design of the electronic module for testing bioimpedance measuring devices, for example impedance cardiographs or impedance pneumographs. Artificial Patient was conceived as an electronic equivalent of the impedance of skin-electrode interface and the impedance between electrodes - measured one. Different approaches in imitating a resistance of skin and an impedance of electrode-skin connection were presented. The module was adapted for frequently applied tetrapolar electrode configuration. Therefore the design do not enclose the elements simulating impedance between skin and receiver electrodes due to negligible effect of this impedance on the current flow through the receiver. The Artificial Patient enables testing either application generators, or receiver parts, particularly the level of noise and distortions of the signal. Use of digitally controlled potentiometer allows simulating different tissue resistances changes such as constant values, very-low-frequency and low-frequency changes corresponding to those caused by breathing or heart activity. Also it allows distorting signals in order to test algorithms of artifacts attenuation.

The Future of Adult Cardiac Assist Devices: Novel Systems and Mechanical Circulatory Support Strategies

PubMed Central

Bartoli, Carlo R.; Dowling, Robert D.

2011-01-01

Synopsis The recent, widespread success of mechanical circulatory support has ushered in a new era of cardiovascular medicine in which numerous implantable devices exist to treat advanced heart failure. As cardiac assist devices gain prevalence in the clinical management of cardiovascular disease, it is increasingly important to raise awareness of novel device systems, the unique mechanisms by which they function, and implications for patient management. In this article, we present state-of-the-art devices that are currently under development or in clinical trials. Devices are categorized as Standard Full-Support (HeartMate III, CorAide, Evaheart LVAS), Less-Invasive Full-Support (MVAD), Partial-Support (CircuLite Synergy Pocket Micro-Pump, Reitan Catheter Pump, Procyrion CAD, C-Pulse, Symphony Counterpulsation Device) Right Ventricular Assist Device (RVAD; DexAide, Impella RD Recover, Impella RP), and Total Artificial Heart (TAH; CardioWest, AbioCor II, Continuous-Flow TAH, Continuous-Flow BiVAD). Implantation strategy, mechanism of action, durability, efficacy, hemocompatibility, and human factors such as quality of life during device support are considered. The feasibility of novel strategies for unloading the failing heart is examined. PMID:22062206

Optimum Heart Rate to Minimize Pulsatile External Cardiac Power

NASA Astrophysics Data System (ADS)

Pahlevan, Niema; Gharib, Morteza

2011-11-01

The workload on the left ventricle is composed of steady and pulsatile components. Clinical investigations have confirmed that an abnormal pulsatile load plays an important role in the pathogenesis of left ventricular hypertrophy (LVH) and progression of LVH to congestive heart failure (CHF). The pulsatile load is the result of the complex dynamics of wave propagation and reflection in the compliant arterial vasculature. We hypothesize that aortic waves can be optimized to reduce the left ventricular (LV) pulsatile load. We used an in-vitro experimental approach to investigate our hypothesis. A unique hydraulic model was used for in-vitro experiments. This model has physical and dynamical properties similar to the heart-aorta system. Different compliant models of the artificial aorta were used to test the hypothesis under various aortic rigidities. Our results indicate that: i) there is an optimum heart rate that minimizes LV pulsatile power (this is in agreement with our previous computational study); ii) introducing an extra reflection site at the specific location along the aorta creates constructive wave conditions that reduce the LV pulsatile power.

Experience with the SynCardia total artificial heart in a Canadian centre

PubMed Central

Nguyen, Anthony; Pellerin, Michel; Perrault, Louis P.; White, Michel; Ducharme, Anique; Racine, Normand; Carrier, Michel

2017-01-01

Background The SynCardia total artificial heart (TAH) provides complete circulatory support by replacing both native ventricles. Accepted indications include bridge to transplantation and destination therapy. We review our experience with TAH implantation during a period when axial flow pump became available. Methods We retrospectively analyzed the demographics, clinical characteristics and survival of all patients receiving the TAH. Results From September 2004 to November 2016, 13 patients (12 men, mean age 45 ± 13 yr) received the TAH for refractory cardiogenic shock secondary to idiopathic (56%) or ischemic (17%) cardiomyopathy and to other various causes (33%). Before implantation, mean ejection fraction was 14% ± 4%, 7 (54%) patients had previous cardiac surgery, 4 (31%) were on mechanical ventilation, and 3 (23%) patients were on dialysis. The mean duration of TAH support was 46 ± 40 days. Three (23%) patients died while on support after a mean of 15 days. Actuarial survival on support was 77% ± 12% at 30 days after implantation. Complications on support included stroke (n = 1, 8%), acute respiratory distress syndrome requiring prolonged intubation (n = 5, 38%) and acute renal failure requiring temporary dialysis (n = 5, 38%). Ten (77%) patients survived to be transplanted after a mean of 52 ± 42 days of support. Actuarial survival rates after transplant were 67% ± 16% at 1 month and 56% ± 17% at 1 year after transplantation. Conclusion The TAH provides an alternative with low incidence of neurologic events in extremely fragile and complex patients waiting for heart transplantation. Complex and unusual anatomic conditions explained the current use of TAH. PMID:28930049

Perioperative Prophylaxis for Total Artificial Heart Transplantation.

PubMed

Chambers, H E; Pelish, P; Qiu, F; Florescu, D F

2017-11-01

Practice variation regarding perioperative antimicrobial prophylaxis in total artificial heart transplantations (TAH-t) across institutions is unknown. The aim of our survey was to assess the current practices for prevention of infection in TAH-t recipients among different programs. An electronic survey was sent to programs that implant Syncardia TAH (Syncardia Systems, Tuscon, Ariz, USA). Proportions were analyzed for categorical variables; means and SDs were analyzed for continuous variables. The majority of centers (80.8%) had a formal surgical infection prophylaxis protocol. For non-penicillin-allergic patients, five (20.1%) institutions reported using a 4-drug regimen, seven (29.2%) used a 3-drug regimen, five (20.1%) used a 2-drug regimen, and seven (29.2%) used a cephalosporin alone. Similar data was seen in the penicillin-allergic patients. Infections were reported to occur postoperatively in 52.2% centers. During the first month after TAH-t, bacteremia represented 27.3%, driveline infections 27.2%, pulmonary infections 9%, and mediastinal infections 18.2%. The most common organisms seen within the first month were Candida spp., Escherichia coli, and Pseudomonas aeruginosa (21.4%). In 65% of centers, the mean rate of death post-TAH-t due to infection was 14.5% (SD, 22.3%). The mean rate of patients surviving until orthotopic heart transplantation was 58.6% (SD, 27.7%). Preventing infections post-TAH-t is key to decreasing morbidity and mortality. All institutions administered perioperative prophylaxis for TAH-t with significant variation among the centers. The majority of the centers have a formal perioperative prophylactic protocol. Copyright © 2017. Published by Elsevier Inc.

Experience with the SynCardia total artificial heart in a Canadian centre.

PubMed

Nguyen, Anthony; Pellerin, Michel; Perrault, Louis P; White, Michel; Ducharme, Anique; Racine, Normand; Carrier, Michel

2017-12-01

The SynCardia total artificial heart (TAH) provides complete circulatory support by replacing both native ventricles. Accepted indications include bridge to transplantation and destination therapy. We review our experience with TAH implantation during a period when axial flow pump became available. We retrospectively analyzed the demographics, clinical characteristics and survival of all patients receiving the TAH. From September 2004 to November 2016, 13 patients (12 men, mean age 45 ± 13 yr) received the TAH for refractory cardiogenic shock secondary to idiopathic (56%) or ischemic (17%) cardiomyopathy and to other various causes (33%). Before implantation, mean ejection fraction was 14% ± 4%, 7 (54%) patients had previous cardiac surgery, 4 (31%) were on mechanical ventilation, and 3 (23%) patients were on dialysis. The mean duration of TAH support was 46 ± 40 days. Three (23%) patients died while on support after a mean of 15 days. Actuarial survival on support was 77% ± 12% at 30 days after implantation. Complications on support included stroke ( n = 1, 8%), acute respiratory distress syndrome requiring prolonged intubation ( n = 5, 38%) and acute renal failure requiring temporary dialysis ( n = 5, 38%). Ten (77%) patients survived to be transplanted after a mean of 52 ± 42 days of support. Actuarial survival rates after transplant were 67% ± 16% at 1 month and 56% ± 17% at 1 year after transplantation. The TAH provides an alternative with low incidence of neurologic events in extremely fragile and complex patients waiting for heart transplantation. Complex and unusual anatomic conditions explained the current use of TAH.

[Animal experimentation, computer simulation and surgical research].

PubMed

Carpentier, Alain

2009-11-01

We live in a digital world In medicine, computers are providing new tools for data collection, imaging, and treatment. During research and development of complex technologies and devices such as artificial hearts, computer simulation can provide more reliable information than experimentation on large animals. In these specific settings, animal experimentation should serve more to validate computer models of complex devices than to demonstrate their reliability.

Years after Inventors Die, Royalties Are Pennies from Heaven

ERIC Educational Resources Information Center

Blumenstyk, Goldie

2009-01-01

Sarah L. Kieweg had her own nice surprise when the University of Central Florida contacted her. She understood quite a bit about her father's pioneering work on artificial intelligence in the 1990s. Still, in 2006, eight years after he died of a heart attack, at age 50, the call from the university came out of the blue: some of James R. Driscoll's…

Thermionic Energy

NASA Technical Reports Server (NTRS)

1985-01-01

Thermionic energy conversion is the production of energy from a nuclear source. It is a technology advanced by SNSO, a joint research and development organization formed by NASA and the AEC. SNSO contracted with Thermo Electron Corporation to develop high temperature applications, i.e., metals with high melting points. Thermo Electron Corporation's expertise resulted in contracts for products made from exotic metals such as bone implants, artificial hips, and heart pacemakers.

Effectiveness of Artificial Gravity and Ergometric Exercise as a Countermeasure-Comparison between Everyday and Every Other Day Protocols

NASA Astrophysics Data System (ADS)

Iwase, Satoshi; Sugenoya, Junichi; Sato, Maki; Shimizu, Yuuki; Kanikowska, Dominika; Nishimura, Nooki; Takada, Hiroki; Takada, Masumi; Mano, Tadaki; Ishida, Koji; Akima, Hiroshi; Katayama, Keisho; Hirayanagi, Kaname; Shiozawa, Tomoki; Yajima, Katzuyoshi; Watanabe, Yoriko; Suzuki, Satomi; Fukunnaga, Tetsuo; Masuo, Yoshihisa

2008-06-01

Effectiveness of centrifuge-induced artificial gravity and ergometric exercise as a countermeasure to space deconditioning, including cardiovascular deconditioning, myatrophy, and osteoporosis, induced by 20 days of head-down bedrest., was examined in 12 healthy men in 2006, and 8 healthy men in 2007. Bedrest was performed with 2300 kcal of diet. Water intake was recommended more than the urine volume in a previous day. A new protocol for artificial gravity with ergometric exercise was adopted, with 1.6 G of artificial gravity at heart level and 60 W of exercise every day in 2006, and every other day in 2007. The load was suspended when subjects complained all-out, and was continued until 30 min cumulative total load time. Gravity was stepped up by 0.2 G or exercise load was stepped up by 15 W alternately when the subject endured the load for 5 min. Gravity tolerance was examined by using centrifuge, and anti-G score was determined before and after the bedrest. Not all result has been analyzed, however, effectiveness of artificial gravity with ergometric exercise was evidenced in orthostatic tolerance, physical fitness, cardiac function, myatrophy, and bone metabolism in everyday protocol, but not in every other day protocol. We concluded this everyday protocol was effective in cardiovascular deconditioning myatrophy, and bone metabolism.

Cardiogenic shock. Current concepts in management.

PubMed

Balakumaran, K; Hugenholtz, P G

1986-10-01

This article presents a categorisation of circulatory shock and discusses the causes, haemodynamics, and clinical recognition of cardiogenic shock. The first step in the management strategy in cardiogenic shock is to guide the patient from the state of shock to one of managed haemodynamic stability. The therapeutic manoeuvres of this first step constitute the management tactics, which can be grouped under 3 general headings: (a) making the most of a malfunctioning heart; (b) improving the state of the heart; and (c) reducing the demands on the heart. In order to make the most of the heart, i.e. to get the highest possible output at the lowest possible cost, clinicians need to use their judgement in stimulating an overtaxed heart on the one hand, and in manipulating the loads on it (the preload and afterload) on the other, for although these methods may be advantageous, they are not without their pitfalls. Efforts to improve the state of the heart often necessitate surgical (e.g. mitral valve replacement) or semisurgical (e.g. coronary angiography and recanalisation) techniques, although intravenous antithrombotic agents may achieve comparable results in a few cases at the bedside. Reducing the demands on the heart is an active process involving the takeover of at least a part of the work of the heart by ancillary devices such as the intra-aortic balloon pump, and of the work of breathing by intubation and artificial ventilation. The individuality of each case of cardiogenic shock emphasises the need for empirical modulation of therapy based on feedback information obtained by haemodynamic monitoring.

Palivizumab prophylaxis during nosocomial outbreaks of respiratory syncytial virus in a neonatal intensive care unit: predicting effectiveness with an artificial neural network model.

PubMed

Saadah, Loai M; Chedid, Fares D; Sohail, Muhammad R; Nazzal, Yazied M; Al Kaabi, Mohammed R; Rahmani, Aiman Y

2014-03-01

To identify subgroups of premature infants who may benefit from palivizumab prophylaxis during nosocomial outbreaks of respiratory syncytial virus (RSV) infection. Retrospective analysis using an artificial intelligence model. Level IIIB, 35-bed, neonatal intensive care unit (NICU) at a tertiary care hospital in the United Arab Emirates. One hundred seventy six premature infants, born at a gestational age of 22-34 weeks, and hospitalized during four RSV outbreaks that occurred between April 2005 and July 2007. We collected demographic and clinical data for each patient by using a standardized form. Input data consisted of seven categoric and continuous variables each. We trained, tested, and validated artificial neural networks for three outcomes of interest: mortality, days of supplemental oxygen, and length of NICU stay after the index case was identified. We compared variable impacts and performed reassignments with live predictions to evaluate the effect of palivizumab. Of the 176 infants, 31 (17.6%) received palivizumab during the outbreaks. All neural network configurations converged within 4 seconds in less than 400 training cycles. Infants who received palivizumab required supplemental oxygen for a shorter duration compared with controls (105.2 ± 7.2 days vs 113.2 ± 10.4 days, p=0.003). This benefit was statistically significant in male infants whose birth weight was less than 0.7 kg and who had hemodynamically significant congenital heart disease. Length of NICU stay after identification of the index case and mortality were independent of palivizumab use. Palivizumab may be an effective intervention during nosocomial outbreaks of RSV in a subgroup of extremely low-birth-weight male infants with hemodynamically significant congenital heart disease. © 2013 Pharmacotherapy Publications, Inc.

A transcutaneous energy transmission system for artificial heart adapting to changing impedance.

PubMed

Fu, Yang; Hu, Liang; Ruan, Xiaodong; Fu, Xin

2015-04-01

This article presents a coil-coupling-based transcutaneous energy transmission system (TETS) for wirelessly powering an implanted artificial heart. Keeping high efficiency is especially important for TETS, which is usually difficult due to transmission impedance changes in practice, which are commonly caused by power requirement variation for different body movements and coil-couple malposition accompanying skin peristalsis. The TETS introduced in this article is designed based on a class-E power amplifier (E-PA), of which efficiency is over 95% when its load is kept in a certain range. A resonance matching and impedance compressing functions coupled network based on parallel-series capacitors is proposed in the design, to enhance the energy transmission efficiency and capacity of the coil-couple through resonating, and meanwhile compress the changing range of the transmission impedance to meet the load requirements of the E-PA and thus keep the high efficiency of TETS. An analytical model of the designed TETS is built to analyze the effect of the network and also provide bases for following parameters determination. Then, according algorithms are provided to determine the optimal parameters required in the TETS for good performance both in resonance matching and impedance compressing. The design is tested by a series of experiments, which validate that the TETS can transmit a wide range of power with a total efficiency of at least 70% and commonly beyond 80%, even when the coil-couple is seriously malpositioned. The design methodology proposed in this article can be applied to any existing TETS based on E-PA to improve their performance in actual applications. Copyright © 2014 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Modeling treatment of ischemic heart disease with partially observable Markov decision processes.

PubMed

Hauskrecht, M; Fraser, H

1998-01-01

Diagnosis of a disease and its treatment are not separate, one-shot activities. Instead they are very often dependent and interleaved over time, mostly due to uncertainty about the underlying disease, uncertainty associated with the response of a patient to the treatment and varying cost of different diagnostic (investigative) and treatment procedures. The framework of Partially observable Markov decision processes (POMDPs) developed and used in operations research, control theory and artificial intelligence communities is particularly suitable for modeling such a complex decision process. In the paper, we show how the POMDP framework could be used to model and solve the problem of the management of patients with ischemic heart disease, and point out modeling advantages of the framework over standard decision formalisms.

Effects of exercise and excitement on mesenteric and renal dynamics in conscious, unrestrained baboons

NASA Technical Reports Server (NTRS)

Vatner, S. F.

1978-01-01

Radiotelemetry was used to measure arterial pressure and mesenteric and renal blood flows from nine unrestrained, conscious baboons during periods of rest, moderate exercise, and extreme excitement. A description of the experiments hardware is presented, including artificial depressants phenylcyclidine hydrochloride, 0.5-1.0 mg/kg, and pentobarbital sodium, 15 mg/kg, and an ultrasonic telemetry flow meter. Results showed rising heart rate and arterial pressure coupled with a reduction of mesenteric and renal flows as the level of exercise was increased. These findings are compared with mesenteric and renal flows somewhat above control level, but relatively stable heart rate and arterial pressure, postprandially. Attention is given to a quantitative analysis of the experimental results.

Simulation of blood flow through an artificial heart

NASA Technical Reports Server (NTRS)

Kiris, Cetin; Chang, I-Dee; Rogers, Stuart E.; Kwak, Dochan

1991-01-01

A numerical simulation of the incompressible viscous flow through a prosthetic tilting disk heart valve is presented in order to demonstrate the current capability to model unsteady flows with moving boundaries. Both steady state and unsteady flow calculations are done by solving the incompressible Navier-Stokes equations in 3-D generalized curvilinear coordinates. In order to handle the moving boundary problems, the chimera grid embedding scheme which decomposes a complex computational domain into several simple subdomains is used. An algebraic turbulence model for internal flows is incorporated to reach the physiological values of Reynolds number. Good agreement is obtained between the numerical results and experimental measurements. It is found that the tilting disk valve causes large regions of separated flow, and regions of high shear.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nose, Y.

Methods were developed for generating an integrated, statistical model of the anatomical structures within the human thorax relevant to radioisotope powered artificial heart implantation. These methods involve measurement and analysis of anatomy in four areas: chest wall, pericardium, vascular connections, and great vessels. A model for the prediction of thorax outline from radiograms was finalized. These models were combined with 100 radiograms to arrive at a size distribution representing the adult male and female populations. (CH)

Long-term in vivo left ventricular assist device study with a titanium centrifugal pump.

PubMed

Ohtsuka, G; Nakata, K; Yoshikawa, M; Mueller, J; Takano, T; Yamane, S; Gronau, N; Glueck, J; Takami, Y; Sueoka, A; Letsou, G; Schima, H; Schmallegger, H; Wolner, E; Koyanagi, H; Fujisawa, A; Baldwin, J C; Nosé, Y

1998-01-01

A totally implantable centrifugal artificial heart has been developed. The plastic prototype, Gyro PI 601, passed 2 day hemodynamic tests as a functional total artificial heart, 2 week screening tests for antithrombogenicity, and 1 month system feasibility. Based on these results, a metallic prototype, Gyro PI 702, was subjected to in vivo left ventricular assist device (LVAD) studies. The pump system employed the Gyro PI 702, which has the same inner dimensions and the same characteristics as the Gyro PI 601, including an eccentric inlet port, a double pivot bearing system, and a magnet coupling system. The PI 702 is driven with the Vienna DC brushless motor actuator. For the in vivo LVAD study, the pump actuator package was implanted in the preperitoneal space in two calves, from the left ventricular apex to the descending aorta. Case 1 achieved greater than 9 month survival without any complications, at an average flow rate of 6.6 L/min with 10.2 W input power. Case 2 was killed early due to the excessive growth of the calf, which caused functional obstruction of the inlet port. There was no blood clot inside the pump. During these periods, neither case exhibited any physiologic abnormalities. The PI 702 pump gives excellent results as a long-term implantable LVAD.

New concepts and new design of permanent maglev rotary artificial heart blood pumps.

PubMed

Qian, K X; Zeng, P; Ru, W M; Yuan, H Y

2006-05-01

According to tradition, permanent maglev cannot achieve stable equilibrium. The authors have developed, to the contrary, two stable permanent maglev impeller blood pumps. The first pump is an axially driven uni-ventricular assist pump, in which the rotor with impeller is radially supported by two passive magnetic bearings, but has one point contact with the stator axially at standstill. As the pump raises its rotating speed, the increasing hydrodynamic force of fluid acting on the impeller will make the rotor taking off from contacting point and disaffiliate from the stator. Then the rotor becomes fully suspended. The second pump is a radially driven bi-ventricular assist pump, i.e., an impeller total artificial heart. Its rotor with two impellers on both ends is supported by two passive magnetic bearings, which counteract the attractive force between rotor magnets and stator coil iron core. The rotor is affiliated to the stator radially at standstill and becomes levitated during rotation. Therefore, the rotor keeps concentric with stator during rotation but eccentric at standstill, as is confirmed by rotor position detection with Honeywell sensors. It concludes that the permanent maglev needs action of a non-magnetic force to achieve stability but a rotating magnetic levitator with high speed and large inertia can maintain its stability merely with passive magnetic bearings.

Analysis of current density and specific absorption rate in biological tissue surrounding transcutaneous transformer for an artificial heart.

PubMed

Shiba, Kenji; Nukaya, Masayuki; Tsuji, Toshio; Koshiji, Kohji

2008-01-01

This paper reports on the current density and specific absorption rate (SAR) analysis of biological tissue surrounding an air-core transcutaneous transformer for an artificial heart. The electromagnetic field in the biological tissue is analyzed by the transmission line modeling method, and the current density and SAR as a function of frequency, output voltage, output power, and coil dimension are calculated. The biological tissue of the model has three layers including the skin, fat, and muscle. The results of simulation analysis show SARs to be very small at any given transmission conditions, about 2-14 mW/kg, compared to the basic restrictions of the International Commission on nonionizing radiation protection (ICNIRP; 2 W/kg), while the current density divided by the ICNIRP's basic restrictions gets smaller as the frequency rises and the output voltage falls. It is possible to transfer energy below the ICNIRP's basic restrictions when the frequency is over 250 kHz and the output voltage is under 24 V. Also, the parts of the biological tissue that maximized the current density differ by frequencies; in the low frequency is muscle and in the high frequency is skin. The boundary is in the vicinity of the frequency 600-1000 kHz.

Analysis of current density and specific absorption rate in biological tissue surrounding an air-core type of transcutaneous transformer for an artificial heart.

PubMed

Shiba, Kenji; Nukaya, Masayuki; Tsuji, Toshio; Koshiji, Kohji

2006-01-01

This paper reports on the specific absorption rate (SAR) and the current density analysis of biological tissue surrounding an air-core type of transcutaneous transformer for an artificial heart. The electromagnetic field in the biological tissue surrounding the transformer was analyzed by the transmission-line modeling method, and the SAR and current density as a function of frequency (200k-1 MHz) for a transcutaneous transmission of 20 W were calculated. The model's biological tissue has three layers including the skin, fat and muscle. As a result, the SAR in the vicinity of the transformer is sufficiently small and the normalized SAR value, which is divided by the ICNIRP's basic restriction, is 7 x 10(-3) or less. On the contrary, the current density is slightly in excess of the ICNIRP's basic restrictions as the frequency falls and the output voltage rises. Normalized current density is from 0.2 to 1.2. In addition, the layer in which the current's density is maximized depends on the frequency, the muscle in the low frequency (<700 kHz) and the skin in the high frequency (>700 kHz). The result shows that precision analysis taking into account the biological properties is very important for developing the transcutaneous transformer for TAH.

Selection and collection of multi parameter physiological data for cardiac rhythm diagnostic algorithm development

NASA Astrophysics Data System (ADS)

Bostock, J.; Weller, P.; Cooklin, M.

2010-07-01

Automated diagnostic algorithms are used in implantable cardioverter-defibrillators (ICD's) to detect abnormal heart rhythms. Algorithms misdiagnose and improved specificity is needed to prevent inappropriate therapy. Knowledge engineering (KE) and artificial intelligence (AI) could improve this. A pilot study of KE was performed with artificial neural network (ANN) as AI system. A case note review analysed arrhythmic events stored in patients ICD memory. 13.2% patients received inappropriate therapy. The best ICD algorithm had sensitivity 1.00, specificity 0.69 (p<0.001 different to gold standard). A subset of data was used to train and test an ANN. A feed-forward, back-propagation network with 7 inputs, a 4 node hidden layer and 1 output had sensitivity 1.00, specificity 0.71 (p<0.001). A prospective study was performed using KE to list arrhythmias, factors and indicators for which measurable parameters were evaluated and results reviewed by a domain expert. Waveforms from electrodes in the heart and thoracic bio-impedance; temperature and motion data were collected from 65 patients during cardiac electrophysiological studies. 5 incomplete datasets were due to technical failures. We concluded that KE successfully guided selection of parameters and ANN produced a usable system and that complex data collection carries greater risk of technical failure, leading to data loss.

Flow Rate Through Pigtail Catheter Used for Left Heart Decompression in an Artificial Model of Extracorporeal Membrane Oxygenation Circuit.

PubMed

Kim, Won Ho; Hong, Tae Hee; Byun, Joung Hun; Kim, Jong Woo; Kim, Sung Hwan; Moon, Sung Ho; Park, Hyun Oh; Choi, Jun Young; Yang, Jun Ho; Jang, In Seok; Lee, Chung Eun; Yun, Jeong Hee

In refractory cardiogenic shock, veno-arterial extracorporeal membrane oxygenation (ECMO) can be initiated. Although left heart decompression can be accomplished by insertion of a left atrial (LA) or left ventricular (LV) cannula using a percutaneous pigtail catheter, the venting flow rate according to catheter size and ECMO flow rate is unknown. We developed an artificial ECMO circuit. One liter saline bag with its pressure set to 20 mm Hg was connected to ECMO to mimic LV failure. A pigtail catheter was inserted into the 1 L saline bag to simulate LV unloading. For each pigtail catheter size (5-8 Fr) and ECMO flow rate (2.0-4.0 L/min), the moving distance of an air bubble that was injected through a three-way stopcock was measured in the arterial pressure line between the pigtail catheter and ECMO inflow limb. The flow rate was then calculated. We obtained the following equation to estimate the pigtail catheter flow rate.Pigtail vent catheter flow rate (ml/min) = 8×ECMOflow rate(L /min)+9×pigtail catheter size(Fr)- 57This equation would aid in designing of a further study to determine optimal venting flow rate. To achieve optimal venting flow, our equation would enable selection of an adequate catheter size.

A mock heart engineered with helical aramid fibers for in vitro cardiovascular device testing.

PubMed

Jansen-Park, So-Hyun; Hsu, Po-Lin; Müller, Indra; Steinseifer, Ulrich; Abel, Dirk; Autschbach, Rüdiger; Rossaint, Rolf; Schmitz-Rode, Thomas

2017-04-01

Mock heart circulation loops (MHCLs) serve as in-vitro platforms to investigate the physiological interaction between circulatory systems and cardiovascular devices. A mock heart (MH) engineered with silicone walls and helical aramid fibers, to mimic the complex contraction of a natural heart, has been developed to advance the MHCL previously developed in our group. A mock aorta with an anatomical shape enables the evaluation of a cannulation method for ventricular assist devices (VADs) and investigation of the usage of clinical measurement systems like pressure-volume catheters. Ventricle and aorta molds were produced based on MRI data and cast with silicone. Aramid fibers were layered in the silicone ventricle to reproduce ventricle torsion. A rotating hollow shaft was connected to the apex enabling the rotation of the MH and the connection of a VAD. Silicone wall thickness, aramid fiber angle and fiber pitch were varied to generate different MH models. All MH models were placed in a tank filled with variable amounts of water and air simulating the compliance. In this work, physiological ventricular torsion angles (15°-26°) and physiological pressure-volume loops were achieved. This MHCL can serve as a comprehensive testing platform for cardiovascular devices, such as artificial heart valves and cannulation of VADs.

Advancements in mechanical circulatory support for patients in acute and chronic heart failure

PubMed Central

Csepe, Thomas A.

2017-01-01

Cardiogenic shock (CS) continues to have high mortality and morbidity despite advances in pharmacological, mechanical, and reperfusion approaches to treatment. When CS is refractory to medical therapy, percutaneous mechanical circulatory support (MCS) should be considered. Acute MCS devices, ranging from intra-aortic balloon pumps (IABPs) to percutaneous temporary ventricular assist devices (VAD) to extracorporeal membrane oxygenation (ECMO), can aid, restore, or maintain appropriate tissue perfusion before the development of irreversible end-organ damage. Technology has improved patient survival to recovery from CS, but in patients whom cardiac recovery does not occur, acute MCS can be effectively utilized as a bridge to long-term MCS devices and/or heart transplantation. Heart transplantation has been limited by donor heart availability, leading to a greater role of left ventricular assist device (LVAD) support. In patients with biventricular failure that are ineligible for LVAD implantation, further advancements in the total artificial heart (TAH) may allow for improved survival compared to medical therapy alone. In this review, we discuss the current state of acute and durable MCS, ongoing advances in LVADs and TAH devices, improved methods of durable MCS implantation and patient selection, and future MCS developments in this dynamic field that may allow for optimization of HF treatment. PMID:29268418

The re-design at the transformer portion of transcutaneous energy transmission system for all implantable devices.

PubMed

Watada, Masaya; Saisho, Ryohei; Kim, Yong-Jae; Ohuchi, Katsuhiro; Takatani, Setsuo; Um, Yong-Su

2007-01-01

All implantable devices, such as an artificial heart, an artificial lung, a pacemaker, a defibrillator, need electric power. So the electric power supply through the skin is requested. Then, it is transcutaneous energy transmission system (TETS) that has been studied and used a lot. TETS is the system which performs an electric power supply by non-contact transcutaneously using the electromagnetic induction phenomenon of an external primary side coil and a secondary side coil in human body. In this research, we are developing the core type TETS which applied for the implantable devices. In this paper, corresponding to various conditions, such as a difference in required electric power and transmission distance change, the core type transformer which can hold high transmission efficiency is designed.

Ancient harbour infrastructure in the Levant: tracking the birth and rise of new forms of anthropogenic pressure.

PubMed

Marriner, Nick; Morhange, Christophe; Kaniewski, David; Carayon, Nicolas

2014-07-03

Beirut, Sidon and Tyre were major centres of maritime trade from the Bronze Age onwards. This economic prosperity generated increased pressures on the local environment, through urbanization and harbour development. Until now, however, the impact of expanding seaport infrastructure has largely been neglected and there is a paucity of data concerning the environmental stresses caused by these new forms of anthropogenic impacts. Sediment archives from Beirut, Sidon and Tyre are key to understanding human impacts in harbour areas because: (i) they lie at the heart of ancient trade networks; (ii) they encompass the emergence of early maritime infrastructure; and (iii) they enable human alterations of coastal areas to be characterized over long timescales. Here we report multivariate analyses of litho- and biostratigraphic data to probe human stressors in the context of their evolving seaport technologies. The statistical outcomes show a notable break between natural and artificial sedimentation that began during the Iron Age. Three anchorage phases can be distinguished: (i) Bronze Age proto-harbours that correspond to natural anchorages, with minor human impacts; (ii) semi-artificial Iron Age harbours, with stratigraphic evidence for artificial reinforcement of the natural endowments; and (iii) heavy human impacts leading to completely artificial Roman and Byzantine harbours.

Ancient harbour infrastructure in the Levant: tracking the birth and rise of new forms of anthropogenic pressure

PubMed Central

Marriner, Nick; Morhange, Christophe; Kaniewski, David; Carayon, Nicolas

2014-01-01

Beirut, Sidon and Tyre were major centres of maritime trade from the Bronze Age onwards. This economic prosperity generated increased pressures on the local environment, through urbanization and harbour development. Until now, however, the impact of expanding seaport infrastructure has largely been neglected and there is a paucity of data concerning the environmental stresses caused by these new forms of anthropogenic impacts. Sediment archives from Beirut, Sidon and Tyre are key to understanding human impacts in harbour areas because: (i) they lie at the heart of ancient trade networks; (ii) they encompass the emergence of early maritime infrastructure; and (iii) they enable human alterations of coastal areas to be characterized over long timescales. Here we report multivariate analyses of litho- and biostratigraphic data to probe human stressors in the context of their evolving seaport technologies. The statistical outcomes show a notable break between natural and artificial sedimentation that began during the Iron Age. Three anchorage phases can be distinguished: (i) Bronze Age proto-harbours that correspond to natural anchorages, with minor human impacts; (ii) semi-artificial Iron Age harbours, with stratigraphic evidence for artificial reinforcement of the natural endowments; and (iii) heavy human impacts leading to completely artificial Roman and Byzantine harbours. PMID:24989979

Effectiveness of centrifuge-induced artificial gravity with ergometric exercise as a countermeasure during simulated microgravity exposure in humans.

PubMed

Iwase, Satoshi

2005-01-01

To test the effectiveness of centrifuge-induced artificial gravity with ergometric exercise, 12 healthy young men (20.7 +/- 1.9 yr) were exposed to simulated microgravity for 14 days of -6 degrees head-down bedrest. Half the subjects were randomly selected and loaded 1.2 G artificial gravity with 60 W (four out of six subjects) or 40 W (two out of six subjects) of ergometric workload on days 1, 2, 3, 5, 7, 9, 11, 12, 13, 14 (CM group). The rest of the subjects served as the control. Anti-G score, defined as the G-load x running time to the endpoint, was significantly elongated by the load of the centrifuge-ergometer. Plasma volume loss was suppressed (-5.0 +/- 2.4 vs. -16.4 +/- 1.9%), and fluid volume shift was prevented by the countermeasure load. Elevated heart rate and muscle sympathetic nerve activity after bedrest were counteracted, and exaggerated response to head-up tilt was also suppressed. Centrifuge-induced artificial gravity with exercise is effective in preventing cardiovascular deconditioning due to microgravity exposure, however, an effective and appropriate regimen (magnitude of G-load and exercise workload) should be determined in future studies. c2005 Elsevier Ltd. All rights reserved.

Ancient harbour infrastructure in the Levant: tracking the birth and rise of new forms of anthropogenic pressure

NASA Astrophysics Data System (ADS)

Marriner, Nick; Morhange, Christophe; Kaniewski, David; Carayon, Nicolas

2014-07-01

Beirut, Sidon and Tyre were major centres of maritime trade from the Bronze Age onwards. This economic prosperity generated increased pressures on the local environment, through urbanization and harbour development. Until now, however, the impact of expanding seaport infrastructure has largely been neglected and there is a paucity of data concerning the environmental stresses caused by these new forms of anthropogenic impacts. Sediment archives from Beirut, Sidon and Tyre are key to understanding human impacts in harbour areas because: (i) they lie at the heart of ancient trade networks; (ii) they encompass the emergence of early maritime infrastructure; and (iii) they enable human alterations of coastal areas to be characterized over long timescales. Here we report multivariate analyses of litho- and biostratigraphic data to probe human stressors in the context of their evolving seaport technologies. The statistical outcomes show a notable break between natural and artificial sedimentation that began during the Iron Age. Three anchorage phases can be distinguished: (i) Bronze Age proto-harbours that correspond to natural anchorages, with minor human impacts; (ii) semi-artificial Iron Age harbours, with stratigraphic evidence for artificial reinforcement of the natural endowments; and (iii) heavy human impacts leading to completely artificial Roman and Byzantine harbours.

Effectiveness of centrifuge-induced artificial gravity with ergometric exercise as a countermeasure during simulated microgravity exposure in humans

NASA Astrophysics Data System (ADS)

Iwase, Satoshi

2005-07-01

To test the effectiveness of centrifuge-induced artificial gravity with ergometric exercise, 12 healthy young men (20.7±1.9yr) were exposed to simulated microgravity for 14 days of -6∘ head-down bedrest. Half the subjects were randomly selected and loaded 1.2 G artificial gravity with 60 W (four out of six subjects) or 40 W (two out of six subjects) of ergometric workload on days 1,2,3,5,7,9,11,12,13,14 (CM group). The rest of the subjects served as the control. Anti-G score, defined as the G-load×running time to the endpoint, was significantly elongated by the load of the centrifuge-ergometer. Plasma volume loss was suppressed ( -5.0±2.4 vs. -16.4±1.9%), and fluid volume shift was prevented by the countermeasure load. Elevated heart rate and muscle sympathetic nerve activity after bedrest were counteracted, and exaggerated response to head-up tilt was also suppressed. Centrifuge-induced artificial gravity with exercise is effective in preventing cardiovascular deconditioning due to microgravity exposure, however, an effective and appropriate regimen (magnitude of G-load and exercise workload) should be determined in future studies.

New continuous-flow total artificial heart and vascular permeability.

PubMed

Feng, Jun; Cohn, William E; Parnis, Steven M; Sodha, Neel R; Clements, Richard T; Sellke, Nicholas; Frazier, O Howard; Sellke, Frank W

2015-12-01

We tested the short-term effects of completely nonpulsatile versus pulsatile circulation after ventricular excision and replacement with total implantable pumps in an animal model on peripheral vascular permeability. Ten calves underwent cardiac replacement with two HeartMate III continuous-flow rotary pumps. In five calves, the pump speed was rapidly modulated to impart a low-frequency pulse pressure in the physiologic range (10-25 mm Hg) at a rate of 40 pulses per minute (PP). The remaining five calves were supported with a pulseless systemic circulation and no modulation of pump speed (NP). Skeletal muscle biopsies were obtained before cardiac replacement (baseline) and on postoperative days (PODs) 1, 7, and 14. Skeletal muscle-tissue water content was measured, and morphologic alterations of skeletal muscle were assessed. VE-cadherin, phospho-VE-cadherin, and CD31 were analyzed by immunohistochemistry. There were no significant changes in tissue water content and skeletal muscle morphology within group or between groups at baseline, PODs 1, 7, and 14, respectively. There were no significant alterations in the expression and/or distribution of VE-cadherin, phospho-VE-cadherin, and CD31 in skeletal muscle vasculature at baseline, PODs 1, 7, and 14 within each group or between the two groups, respectively. Although continuous-flow total artificial heart (CFTAH) with or without a pulse pressure caused slight increase in tissue water content and histologic damage scores at PODs 7 and 14, it failed to reach statistical significance. There was no significant adherens-junction protein degradation and phosphorylation in calf skeletal muscle microvasculature after CFTAH implantation, suggesting that short term of CFTAH with or without pulse pressure did not cause peripheral endothelial injury and did not increase the peripheral microvascular permeability. Copyright © 2015 Elsevier Inc. All rights reserved.

The challenge of home discharge with a total artificial heart: the La Pitie Salpetriere experience.

PubMed

Demondion, Pierre; Fournel, Ludovic; Niculescu, Michaela; Pavie, Alain; Leprince, Pascal

2013-11-01

The total artificial heart (TAH) helps to counteract the current decrease in heart donors and is likely to bridge patients to transplant under favourable conditions. Today's mobile consoles facilitate home discharge. The aim of this study was to report on the La Pitie Hospital experience with CardioWest TAH recipients, and more particularly, on generally successful outpatient' management. A retrospective analysis was performed on clinical and biological data from patients implanted with a TAH between December 2006 and July 2010 in a single institution. Morbi-mortality during hospital stay, number and causes of rehospitalizations, quality of life during home discharge, bridge to transplant results and survival have all been analysed. Twenty-seven patients were implanted with the CardioWest. Fifteen patients (55.5%) died during support. Prior to home discharge, the most frequent cause of death was multi-organ failure (46.6%). Twelve patients were discharged home from hospital within a median of 88 days [range 35-152, interquartile range 57] postimplantation. Mean rehospitalization rate was 1.2 by patient, on account of device infection (n = 7), technical problems with the console (n = 3) and other causes (n = 4). Between discharge and transplant, patients spent 87% of their support time out of hospital. All patients who returned home with the TAH were subsequently transplanted, and 1 died in post-transplant. Despite the morbidity and mortality occurring during the postimplantation period, home discharge with a TAH is possible. Portables drivers allow for a safe return home. Aside from some remaining weak points such as infectious complications or noise, CardioWest TAH allows for successful rehabilitation of graft candidates, and assures highly satisfactory transplant results.

A remote monitoring system for patients with implantable ventricular assist devices with a personal handy phone system.

PubMed

Okamoto, E; Shimanaka, M; Suzuki, S; Baba, K; Mitamura, Y

1999-01-01

The usefulness of a remote monitoring system that uses a personal handy phone for artificial heart implanted patients was investigated. The type of handy phone used in this study was a personal handy phone system (PHS), which is a system developed in Japan that uses the NTT (Nippon Telephone and Telegraph, Inc.) telephone network service. The PHS has several advantages: high-speed data transmission, low power output, little electromagnetic interference with medical devices, and easy locating of patients. In our system, patients have a mobile computer (Toshiba, Libretto 50, Kawasaki, Japan) for data transmission control between an implanted controller and a host computer (NEC, PC-9821V16) in the hospital. Information on the motor rotational angle (8 bits) and motor current (8 bits) of the implanted motor driven heart is fed into the mobile computer from the implanted controller (Hitachi, H8/532, Yokohama, Japan) according to 32-bit command codes from the host computer. Motor current and motor rotational angle data from inside the body are framed together by a control code (frame number and parity) for data error checking and correcting at the receiving site, and the data are sent through the PHS connection to the mobile computer. The host computer calculates pump outflow and arterial pressure from the motor rotational angle and motor current values and displays the data in real-time waveforms. The results of this study showed that accurate data on motor rotational angle and current could be transmitted from the subjects while they were walking or driving a car to the host computer at a data transmission rate of 9600 bps. This system is useful for remote monitoring of patients with an implanted artificial heart.

Effects of intra-aortic balloon pump timing on baroreflex activities in a closed-loop cardiovascular hybrid model.

PubMed

Fresiello, Libera; Khir, Ashraf William; Di Molfetta, Arianna; Kozarski, Maciej; Ferrari, Gianfranco

2013-03-01

Despite 50 years of research to assess the intra-aortic balloon pump (IABP) effects on patients' hemodynamics, some issues related to the effects of this therapy are still not fully understood. One of these issues is the effect of IABP, its inflation timing and duration on peripheral circulation autonomic controls. This work provides a systematic analysis of IABP effects on baroreflex using a cardiovascular hybrid model, which consists of computational and hydraulic submodels. The work also included a baroreflex computational model that was connected to a hydraulic model with a 40-cm(3) balloon. The IABP was operated at different inflation trigger timings (-0.14 to 0.31 s) and inflation durations (0.05-0.45 s), with time of the dicrotic notch being taken as t = 0. Baroreflex-dependent parameters-afferent and efferent pathway activity, heart rate, peripheral resistance, and venous tone-were evaluated at each of the inflation trigger times and durations considered. Balloon early inflation (0.09 s before the dicrotic notch) with inflation duration of 0.25 s generated a maximum net increment of afferent pathway activity of 10%, thus leading to a decrement of efferent sympathetic activity by 15.3% compared with baseline values. These times also resulted in a reduction in peripheral resistance and heart rate by 4 and 4.3% compared with baseline value. We conclude that optimum IABP triggering time results in positive effects on peripheral circulation autonomic controls. Conversely, if the balloon is not properly timed, peripheral resistance and heart rate may even increase, which could lead to detrimental outcomes. © 2012, Copyright the Authors. Artificial Organs © 2012, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Pulsatility flow around a single cylinder - an experimental model of flow inside an artificial lung

NASA Astrophysics Data System (ADS)

Lin, Yu-Chun; Bull, Joseph L.

2004-11-01

Pulsatile flow past a single cylinder is experimentally investigated using particle image velocimetry. This study aims to elucidate the effects of pulstility on the velocity field, which influences the convection-dominated transport within the fluid. The artificial lung device can be connected in parallel or series with the native lungs and may potentially be used as a bridge to transplant or for pulmonary replacement. The artificial lung consists of hollow microfibers through which gas flows and blood flows around. Blood flow through the device is pulsatile because it is driven entirely by the right heart. Steady flow over bluff bodies has been investigated in many contexts, such as heat exchangers. However, few studies have been investigated the effect of pulsatility. The effects of frequency, amplitude of pulsatility, and average flow rate on the formation of vortices after a cylinder are examined. Vortices near the cylinder are found to develop at lower Reynolds number in pulsatile flow than in steady flow. This work is supported by NIH grant R01 HL69420-01.

Computational Hemodynamics Involving Artificial Devices

NASA Technical Reports Server (NTRS)

Kwak, Dochan; Kiris, Cetin; Feiereisen, William (Technical Monitor)

2001-01-01

This paper reports the progress being made towards developing complete blood flow simulation capability in human, especially, in the presence of artificial devices such as valves and ventricular assist devices. Devices modeling poses unique challenges different from computing the blood flow in natural hearts and arteries. There are many elements needed such as flow solvers, geometry modeling including flexible walls, moving boundary procedures and physiological characterization of blood. As a first step, computational technology developed for aerospace applications was extended in the recent past to the analysis and development of mechanical devices. The blood flow in these devices is practically incompressible and Newtonian, and thus various incompressible Navier-Stokes solution procedures can be selected depending on the choice of formulations, variables and numerical schemes. Two primitive variable formulations used are discussed as well as the overset grid approach to handle complex moving geometry. This procedure has been applied to several artificial devices. Among these, recent progress made in developing DeBakey axial flow blood pump will be presented from computational point of view. Computational and clinical issues will be discussed in detail as well as additional work needed.

A thin film nitinol heart valve.

PubMed

Stepan, Lenka L; Levi, Daniel S; Carman, Gregory P

2005-11-01

In order to create a less thrombogenic heart valve with improved longevity, a prosthetic heart valve was developed using thin film nitinol (NiTi). A "butterfly" valve was constructed using a single, elliptical piece of thin film NiTi and a scaffold made from Teflon tubing and NiTi wire. Flow tests and pressure readings across the valve were performed in vitro in a pulsatile flow loop. Bio-corrosion experiments were conducted on untreated and passivated thin film nitinol. To determine the material's in vivo biocompatibility, thin film nitinol was implanted in pigs using stents covered with thin film NiTi. Flow rates and pressure tracings across the valve were comparable to those through a commercially available 19 mm Perimount Edwards tissue valve. No signs of corrosion were present on thin film nitinol samples after immersion in Hank's solution for one month. Finally, organ and tissue samples explanted from four pigs at 2, 3, 4, and 6 weeks after thin film NiTi implantation appeared without disease, and the thin film nitinol itself was without thrombus formation. Although long term testing is still necessary, thin film NiTi may be very well suited for use in artificial heart valves.

Hybrid systems analysis of the control of burst duration by low-voltage-activated calcium current in leech heart interneurons.

PubMed

Olypher, Andrey; Cymbalyuk, Gennady; Calabrese, Ronald L

2006-12-01

The leech heartbeat CPG is paced by the alternating bursting of pairs of mutually inhibitory heart interneurons that form elemental half-center oscillators. We explore the control of burst duration in heart interneurons using a hybrid system, where a living, pharmacologically isolated, heart interneuron is connected with artificial synapses to a model heart interneuron running in real-time, by focusing on a low-voltage-activated (LVA) calcium current I(CaS). The transition from silence to bursting in this half-center oscillator occurs when the spike frequency of the bursting interneuron declines to a critical level, f(Final), at which the inhibited interneuron escapes owing to a build-up of the hyperpolarization-activated cation current, I(h). We varied I(CaS) inactivation time constant either in the living heart interneuron or in the model heart interneuron. In both cases, varying I(CaS) inactivation time constant did not affect f(Final) of either interneuron, but in the varied interneuron, the time constant of decline of spike frequency during bursts to f(Final) and thus the burst duration varied directly and nearly linearly with I(CaS) inactivation time constant. Bursts of the opposite, nonvaried interneuron did not change. We show also that control of burst duration by I(CaS) inactivation does not require synaptic interaction by reconstituting autonomous bursting in synaptically isolated living interneurons with injected I(CaS). Therefore inactivation of LVA calcium current is critically important for setting burst duration and thus period in a heart interneuron half-center oscillator and is potentially a general intrinsic mechanism for regulating burst duration in neurons.

Impedimetric Analysis of the Effect of Decellularized Porcine Heart Scaffold on Human Fibrosarcoma, Endothelial, and Cardiomyocyte Cell Lines

PubMed Central

Bäcker, Henrik; Polgár, Livia; Soós, Pal; Lajkó, Eszter; Láng, Orsolya; Merkely, Bela; Szabó, Gabor; Dohmen, Pascal M.; Weymann, Alexander; Kőhidai, Laszlo

2017-01-01

Background Experiments on porcine heart scaffold represent significant assays in development of immunoneutral materials for cardiac surgery. Characterization of cell-cell and cell-scaffold interactions is essential to understand the homing process of cardiac cells into the scaffolds. Material/Methods In the present study, the highly sensitive and real-time impedimetric technique of xCELLigence SP was used to monitor cell adhesion, which is the key process of recellularization in heart scaffolds. Our objectives were: (i) to characterize the effect of decellularized porcine heart scaffold on cell adhesion of human cardiovascular cells potentially used in the recellularization process; and (ii) to investigate cell-extracellular matrix element interactions for building artificial multi-layer systems, applied as cellular models of recellularization experiments. Human fibrosarcoma, endothelial, and cardiomyocyte cells were investigated and the effect of decellularized porcine heart scaffold (HS) and fibronectin on cell adhesion was examined. Adhesion was quantified as slope of curves. Results Heart scaffold had neutral effect on cardiomyocytes as well as on endothelial cells. Adhesion of cardiomyocytes was increased by fibronectin (1.480±0.021) compared to control (0.745±0.029). The combination of fibronectin and HS induced stronger adhesion of cardiomyocytes (2.407±0.634) than fibronectin alone. Endothelial and fibrosarcoma cells showed similarly strong adhesion profiles with marked enhancer effect by fibronectin. Conclusions Decellularized porcine HS does not inhibit adhesion of human cardiovascular cells at the cell biological level, while fibronectin has strong cell adhesion-inducer effect, as well as an enhancer effect on activity of HS. Consequently, decellularized porcine hearts could be used as scaffolds for recellularization with cardiomyocytes and endothelial cells with fibronectin acting as a regulator, leading to construction of working bioartificial hearts. PMID:28493851

Cardio-supportive devices (VRD & DCC device) and patches for advanced heart failure: A review, summary of state of the art and future directions.

PubMed

Naveed, Muhammad; Han, Lei; Khan, Ghulam Jilany; Yasmeen, Sufia; Mikrani, Reyaj; Abbas, Muhammad; Cunyu, Li; Xiaohui, Zhou

2018-06-01

Congestive heart failure (CHF) is a complicated pathophysiological syndrome, leading cause of hospitalization as well as mortalities in developed countries wherein an irregular function of the heart leads to the insufficient blood supply to the body organs. It is an accumulative slackening of various complications including myocardial infarction (MI), coronary heart disease (CAD), hypertension, valvular heart disease (VHD) and cardiomyopathy; its hallmarks include hypertrophy, increased interstitial fibrosis and loss of myocytes. The etiology of CHF is very complex and despite the rapid advancement in pharmacological and device-based interventional therapies still, a single therapy may not be sufficient to meet the demand for coping with the diseases. Total artificial hearts (TAH) and ventricular assist devices (VADs) have been widely used clinically to assist patients with severe HF. Unfortunately, direct contact between the patient's blood and device leads to thromboembolic events, and then coagulatory factors, as well as, infection contribute significantly to complicate the situation. There is no effective treatment of HF except cardiac transplantation, however, genetic variations, tissue mismatch; differences in certain immune response and socioeconomic crisis are an important concern with cardiac transplantation suggesting an alternate bridge to transplant (BTT) or destination therapies (DT). For these reasons, researchers have turned to mechanically driven compression devices, ventricular restraint devices (VRD) and heart patches. The ASD is a combination of all operational patches and cardiac support devices (CSD) by delivering biological agents and can restrain or compress the heart. Present study summarizes the accessible peer-reviewed literature focusing on the mechanism of Direct Cardiac Compression (DCC) devices, VRD and patches and their acquaintance to optimize the therapeutic efficacy in a synergistic way. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Planning treatment of ischemic heart disease with partially observable Markov decision processes.

PubMed

Hauskrecht, M; Fraser, H

2000-03-01

Diagnosis of a disease and its treatment are not separate, one-shot activities. Instead, they are very often dependent and interleaved over time. This is mostly due to uncertainty about the underlying disease, uncertainty associated with the response of a patient to the treatment and varying cost of different diagnostic (investigative) and treatment procedures. The framework of partially observable Markov decision processes (POMDPs) developed and used in the operations research, control theory and artificial intelligence communities is particularly suitable for modeling such a complex decision process. In this paper, we show how the POMDP framework can be used to model and solve the problem of the management of patients with ischemic heart disease (IHD), and demonstrate the modeling advantages of the framework over standard decision formalisms.

Combined application of extracorporeal membrane oxygenation and an artificial pacemaker in fulminant myocarditis in a child

PubMed Central

Ye, Sheng; Zhu, Lvchan; Ning, Botao; Zhang, Chenmei

2017-01-01

Fulminant myocarditis is severe and aggressive, but it is self-limited and usually has a favorable prognosis if the patients can survive the acute phase. When drug treatment is not effective, extracorporeal membrane oxygenation technology should be applied to support cardiopulmonary function. Extracorporeal membrane oxygenation can simultaneously support function of the left ventricle, right ventricle, and lungs, and provide stable blood circulation for patients with heart and respiratory failure, which allows sufficient time for the cardiopulmonary system to recover. Fulminant myocarditis affects cardiac systolic function, as well as the function of autorhythmic cells and the conduction system. If severe bradycardia or atrioventricular block appears, a pacemaker needs to be installed. We report a child with fulminant myocarditis who was treated with extracorporeal membrane oxygenation combined with an artificial pacemaker. PMID:28747842

Combined application of extracorporeal membrane oxygenation and an artificial pacemaker in fulminant myocarditis in a child.

PubMed

Ye, Sheng; Zhu, Lvchan; Ning, Botao; Zhang, Chenmei

2017-06-01

Fulminant myocarditis is severe and aggressive, but it is self-limited and usually has a favorable prognosis if the patients can survive the acute phase. When drug treatment is not effective, extracorporeal membrane oxygenation technology should be applied to support cardiopulmonary function. Extracorporeal membrane oxygenation can simultaneously support function of the left ventricle, right ventricle, and lungs, and provide stable blood circulation for patients with heart and respiratory failure, which allows sufficient time for the cardiopulmonary system to recover. Fulminant myocarditis affects cardiac systolic function, as well as the function of autorhythmic cells and the conduction system. If severe bradycardia or atrioventricular block appears, a pacemaker needs to be installed. We report a child with fulminant myocarditis who was treated with extracorporeal membrane oxygenation combined with an artificial pacemaker.

Dynamic three-dimensional phase-contrast technique in MRI: application to complex flow analysis around the artificial heart valve

NASA Astrophysics Data System (ADS)

Kim, Soo Jeong; Lee, Dong Hyuk; Song, Inchang; Kim, Nam Gook; Park, Jae-Hyeung; Kim, JongHyo; Han, Man Chung; Min, Byong Goo

1998-07-01

Phase-contrast (PC) method of magnetic resonance imaging (MRI) has bee used for quantitative measurements of flow velocity and volume flow rate. It is a noninvasive technique which provides an accurate two-dimensional velocity image. Moreover, Phase Contrast Cine magnetic resonance imaging combines the flow dependent contrast of PC-MRI with the ability of cardiac cine imaging to produce images throughout the cardiac cycle. However, the accuracy of the data acquired from the single through-plane velocity encoding can be reduced by the effect of flow direction, because in many practical cases flow directions are not uniform throughout the whole region of interest. In this study, we present dynamic three-dimensional velocity vector mapping method using PC-MRI which can visualize the complex flow pattern through 3D volume rendered images displayed dynamically. The direction of velocity mapping can be selected along any three orthogonal axes. By vector summation, the three maps can be combined to form a velocity vector map that determines the velocity regardless of the flow direction. At the same time, Cine method is used to observe the dynamic change of flow. We performed a phantom study to evaluate the accuracy of the suggested PC-MRI in continuous and pulsatile flow measurement. Pulsatile flow wave form is generated by the ventricular assistant device (VAD), HEMO-PULSA (Biomedlab, Seoul, Korea). We varied flow velocity, pulsatile flow wave form, and pulsing rate. The PC-MRI-derived velocities were compared with Doppler-derived results. The velocities of the two measurements showed a significant linear correlation. Dynamic three-dimensional velocity vector mapping was carried out for two cases. First, we applied to the flow analysis around the artificial heart valve in a flat phantom. We could observe the flow pattern around the valve through the 3-dimensional cine image. Next, it is applied to the complex flow inside the polymer sac that is used as ventricle in totally implantable artificial heart (TAH). As a result we could observe the flow pattern around the valves of the sac, though complex flow can not be detected correctly in the conventional phase contrast method. In addition, we could calculate the cardiac output from TAH sac by quantitative measurement of the volume of flow across the outlet valve.

Pulsatile flow and mass transport over an array of cylinders: gas transfer in a cardiac-driven artificial lung.

PubMed

Chan, Kit Yan; Fujioka, Hideki; Bartlett, Robert H; Hirschl, Ronald B; Grotberg, James B

2006-02-01

The pulsatile flow and gas transport of a Newtonian passive fluid across an array of cylindrical microfibers are numerically investigated. It is related to an implantable, artificial lung where the blood flow is driven by the right heart. The fibers are modeled as either squared or staggered arrays. The pulsatile flow inputs considered in this study are a steady flow with a sinusoidal perturbation and a cardiac flow. The aims of this study are twofold: identifying favorable array geometry/spacing and system conditions that enhance gas transport; and providing pressure drop data that indicate the degree of flow resistance or the demand on the right heart in driving the flow through the fiber bundle. The results show that pulsatile flow improves the gas transfer to the fluid compared to steady flow. The degree of enhancement is found to be significant when the oscillation frequency is large, when the void fraction of the fiber bundle is decreased, and when the Reynolds number is increased; the use of a cardiac flow input can also improve gas transfer. In terms of array geometry, the staggered array gives both a better gas transfer per fiber (for relatively large void fraction) and a smaller pressure drop (for all cases). For most cases shown, an increase in gas transfer is accompanied by a higher pressure drop required to power the flow through the device.

Long-term in vivo left ventricular assist device study for 284 days with Gyro PI pump.

PubMed

Ohtsuka, G; Nakata, K; Yoshikawa, M; Takano, T; Glueck, J; Sankai, Y; Takami, Y; Mueller, J; Sueoka, A; Letsou, G; Schima, H; Schmallegger, H; Wolner, E; Koyanagi, H; Fujisawa, A; Baldwin, J C; Nosé, Y

1999-06-01

A totally implantable centrifugal artificial heart has been developed. The plastic prototype, the Gyro PI 601, passed 2 day hemodynamic tests as a functional total artificial heart (TAH), 2 week screening tests for anti-thrombogenecity, and a 1 month system feasibility study. Based upon these results, a metallic prototype, the Gyro PI 700 series, was subjected to long-term in vivo left ventricular assist device (LVAD) studies of over 1 month. The Gyro PI 700 series has the same inner dimension and same characteristics of the Gyro PI 601 such as an eccentric inlet port, a double pivot bearing system, and a magnet coupling system. The PI metallic pump is also driven with the Vienna DC brushless motor actuator like the PI 601. The pump-actuator package was implanted in 3 calves in the preperitoneal space, bypassing from the left ventricular (LV) apex to the descending aorta. Case 1 achieved a 284 day survival. Case 2 was euthanized early at 72 postoperative days as a result of the functional obstruction of the inlet port due to the excessive growth of the calf. There was no blood clot inside the pumps of either case. Case 3 is on-going (22 days on July 24, 1998). During these periods, all cases showed no physiological abnormalities. In conclusion, the PI 700 series pump has excellent results as a long-term implantable LVAD.

Appropriate control time constant in relation to characteristics of the baroreflex vascular system in 1/R control of the total artificial heart.

PubMed

Mizuta, Sora; Saito, Itsuro; Isoyama, Takashi; Hara, Shintaro; Yurimoto, Terumi; Li, Xinyang; Murakami, Haruka; Ono, Toshiya; Mabuchi, Kunihiko; Abe, Yusuke

2017-09-01

1/R control is a physiological control method of the total artificial heart (TAH) with which long-term survival was obtained with animal experiments. However, 1/R control occasionally diverged in the undulation pump TAH (UPTAH) animal experiment. To improve the control stability of the 1/R control, appropriate control time constant in relation to characteristics of the baroreflex vascular system was investigated with frequency analysis and numerical simulation. In the frequency analysis, data of five goats in which the UPTAH was implanted were analyzed with first Fourier transform technique to examine the vasomotion frequency. The numerical simulation was carried out repeatedly changing baroreflex parameters and control time constant using the elements-expanded Windkessel model. Results of the frequency analysis showed that the 1/R control tended to diverge when very low frequency band that was an indication of the vasomotion frequency was relative high. In numerical simulation, divergence of the 1/R control could be reproduced and the boundary curves between the divergence and convergence of the 1/R control varied depending on the control time constant. These results suggested that the 1/R control tended to be unstable when the TAH recipient had high reflex speed in the baroreflex vascular system. Therefore, the control time constant should be adjusted appropriately with the individual vasomotion frequency.

Patient with a total artificial heart maintained on outpatient dialysis while listed for combined organ transplant, a single center experience.

PubMed

Hanna, Ramy M; Hasnain, Huma; Kamgar, Mohammad; Hanna, Mina; Minasian, Raffi; Wilson, James

2017-10-01

Advanced mechanical circulatory support is increasingly being used with more sophisticated devices that can deliver pulsatile rather than continuous flow. These devices are more portable as well, allowing patients to await cardiac transplantation in an outpatient setting. It is known that patients with renal failure are at increased risk for developing worsening acute kidney injury during implantation of a ventricular assist device (VAD) or more advanced modalities like a total artificial heart (TAH). Dealing with patients who have an implanted TAH who develop renal failure has been a challenge with the majority of such patients having to await a combined cardiac and renal transplant prior to transition to outpatient care. Protocols do exist for VAD implanted patients to be transitioned to outpatient dialysis care, but there are no reported cases of TAH patients with end stage renal disease (ESRD) being successfully transitioned to outpatient dialysis care. In this report, we identify a patient with a TAH and ESRD transitioned successfully to outpatient hemodialysis and maintained for more than 2 years, though he did not survive to transplant. It is hoped that this report will raise awareness of this possibility, and assist in the development of protocols for similar patients to be successfully transitioned to outpatient dialysis care. © 2017 International Society for Hemodialysis.

Multi-Targeted Antithrombotic Therapy for Total Artificial Heart Device Patients.

PubMed

Ramirez, Angeleah; Riley, Jeffrey B; Joyce, Lyle D

2016-03-01

To prevent thrombotic or bleeding events in patients receiving a total artificial heart (TAH), agents have been used to avoid adverse events. The purpose of this article is to outline the adoption and results of a multi-targeted antithrombotic clinical procedure guideline (CPG) for TAH patients. Based on literature review of TAH anticoagulation and multiple case series, a CPG was designed to prescribe the use of multiple pharmacological agents. Total blood loss, Thromboelastograph(®) (TEG), and platelet light-transmission aggregometry (LTA) measurements were conducted on 13 TAH patients during the first 2 weeks of support in our institution. Target values and actual medians for postimplant days 1, 3, 7, and 14 were calculated for kaolinheparinase TEG, kaolin TEG, LTA, and estimated blood loss. Protocol guidelines were followed and anticoagulation management reduced bleeding and prevented thrombus formation as well as thromboembolic events in TAH patients postimplantation. The patients in this study were susceptible to a variety of possible complications such as mechanical device issues, thrombotic events, infection, and bleeding. Among them all it was clear that patients were at most risk for bleeding, particularly on postoperative days 1 through 3. However, bleeding was reduced into postoperative days 3 and 7, indicating that acceptable hemostasis was achieved with the anticoagulation protocol. The multidisciplinary, multi-targeted anticoagulation clinical procedure guideline was successful to maintain adequate antithrombotic therapy for TAH patients.

Visual three-dimensional representation of beat-to-beat electrocardiogram traces during hemodiafiltration.

PubMed

Rodriguez-Fernandez, Rodrigo; Infante, Oscar; Perez-Grovas, Héctor; Hernandez, Erika; Ruiz-Palacios, Patricia; Franco, Martha; Lerma, Claudia

2012-06-01

This study evaluated the usefulness of the three-dimensional representation of electrocardiogram traces (3DECG) to reveal acute and gradual changes during a full session of hemodiafiltration (HDF) in end-stage renal disease (ESRD) patients. Fifteen ESRD patients were included (six men, nine women, age 46 ± 19 years old). Serum electrolytes, blood pressure, heart rate, and blood urea nitrogen (BUN) were measured before and after HDF. Continuous electrocardiograms (ECGs) obtained by Holter monitoring during HDF were used to produce the 3DECG. Several major disturbances were identified by 3DECG images: increase in QRS amplitude (47%), decrease in T-wave amplitude (33%), increase in heart rate (33%), and occurrence of arrhythmia (53%). Different arrhythmia types were often concurrent and included isolated supraventricular premature beats (N = 5), atrial fibrillation or atrial bigeminy (N = 2), and isolated premature ventricular beats (N = 6). Patients with decrease in T-wave amplitude had higher potassium and BUN (both before HDF and total removal) than those without decrease in T-wave amplitude (P < 0.05). Concurrent acute and gradual ECG changes during HDF are identified by the 3DECG, which could be useful as a preventive and prognostic method. © 2011, Copyright the Authors. Artificial Organs © 2011, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

The influence of the playing surface on the exercise intensity of small-sided recreational soccer games.

PubMed

Brito, João; Krustrup, Peter; Rebelo, António

2012-08-01

This study aimed to analyze the influence of the playing surface on movement pattern, physical loading, perceived exertion, and fatigue development during small-sided recreational soccer games. Time-motion, heart rate, blood lactate, and perceived exertion were measured for 16 recreational players aged 22 (range: 19-35) yrs. During 5-a-side soccer games on 3 different field surfaces: sand, artificial turf, and asphalt. Jump and sprint tests were performed prior to and after each game. Total distance covered was higher on asphalt and turf than on sand (3.89±0.04 and 3.73±0.12 vs. 2.59±0.21 km; p<.01), and the number of high-intensity runs was higher on asphalt than on turf (55±3 vs. 43±3; p<.05), but not sand (46±6). Mean heart rate (means±SEM, 160±3 vs. 171±1 b.p.m.) and time>90% HR(max) (20.8±5.1% vs. 44.1±5.0%) were lower (p<.05) on asphalt than on turf, with intermediate values for sand. Blood lactate was lower on asphalt than on sand (2.8±0.3 vs. 4.7±0.6 mmolL(-1); p<.05). Perceived exertion was lower on asphalt than on turf and sand (VAS 0-100: 52±3 vs. 72±3 and 72±3; p<.01). After the game, squat and countermovement jump performances were lower (4.9-8.1%, and 1.9-6.4%, respectively; p<.001) for all field surfaces, but no changes were observed in 5- and 30-m sprint performance. Small-sided recreational soccer games elicit high heart rates, multiple intense actions, and decreased jump performance for all the investigated playing surfaces, suggesting that multiple fitness and health benefits can be achieved through soccer on sand, artificial turf and asphalt. Nonetheless, locomotor activities, heart rate, blood lactate levels, and perceived exertion differ between surfaces. Copyright © 2012 Elsevier B.V. All rights reserved.

Comparison of electron-beam and ungated helical CT in detecting coronary arterial calcification by using a working heart phantom and artificial coronary arteries.

PubMed

Hopper, Kenneth D; Strollo, Diane C; Mauger, David T

2002-02-01

To determine the sensitivity and specificity of cardiac gated electron-beam computed tomography (CT) and ungated helical CT in detecting and quantifying coronary arterial calcification (CAC) by using a working heart phantom and artificial coronary arteries. A working heart phantom simulating normal cardiac motion and providing attenuation equal to that of an adult thorax was used. Thirty tubes with a 3-mm inner diameter were internally coated with pulverized human cortical bone mixed with epoxy glue to simulate minimal (n = 10), mild (n = 10), or severe (n = 10) calcified plaques. Ten additional tubes were not coated and served as normal controls. The tubes were attached to the same location on the phantom heart and scanned with electron-beam CT and helical CT in horizontal and vertical planes. Actual plaque calcium content was subsequently quantified with atopic spectroscopy. Two blinded experienced radiologic imaging teams, one for each CT system, separately measured calcium content in the model vessels by using a Hounsfield unit threshold of 130 or greater. The sensitivity and specificity of electron-beam CT in detecting CAC were 66.1% and 80.0%, respectively. The sensitivity and specificity of helical CT were 96.4% and 95.0%, respectively. Electron-beam CT was less reliable when vessels were oriented vertically (sensitivity and specificity, 71.4% and 70%; 95% CI: 39.0%, 75.0%) versus horizontally (sensitivity and specificity, 60.7% and 90.0%; 95% CI: 48.0%, 82.0%). When a correction factor was applied, the volume of calcified plaque was statistically better quantified with helical CT than with electron-beam CT (P =.004). Ungated helical CT depicts coronary arterial calcium better than does gated electron-beam CT. When appropriate correction factors are applied, helical CT is superior to electron-beam CT in quantifying coronary arterial calcium. Although further work must be done to optimize helical CT grading systems and scanning protocols, the data of this study demonstrated helical CT's inherent advantage over currently commercially available electron-beam CT systems in CAC detection and quantification.

Using Artificial Intelligence to Reduce the Risk of Nonadherence in Patients on Anticoagulation Therapy.

PubMed

Labovitz, Daniel L; Shafner, Laura; Reyes Gil, Morayma; Virmani, Deepti; Hanina, Adam

2017-05-01

This study evaluated the use of an artificial intelligence platform on mobile devices in measuring and increasing medication adherence in stroke patients on anticoagulation therapy. The introduction of direct oral anticoagulants, while reducing the need for monitoring, have also placed pressure on patients to self-manage. Suboptimal adherence goes undetected as routine laboratory tests are not reliable indicators of adherence, placing patients at increased risk of stroke and bleeding. A randomized, parallel-group, 12-week study was conducted in adults (n=28) with recently diagnosed ischemic stroke receiving any anticoagulation. Patients were randomized to daily monitoring by the artificial intelligence platform (intervention) or to no daily monitoring (control). The artificial intelligence application visually identified the patient, the medication, and the confirmed ingestion. Adherence was measured by pill counts and plasma sampling in both groups. For all patients (n=28), mean (SD) age was 57 years (13.2 years) and 53.6% were women. Mean (SD) cumulative adherence based on the artificial intelligence platform was 90.5% (7.5%). Plasma drug concentration levels indicated that adherence was 100% (15 of 15) and 50% (6 of 12) in the intervention and control groups, respectively. Patients, some with little experience using a smartphone, successfully used the technology and demonstrated a 50% improvement in adherence based on plasma drug concentration levels. For patients receiving direct oral anticoagulants, absolute improvement increased to 67%. Real-time monitoring has the potential to increase adherence and change behavior, particularly in patients on direct oral anticoagulant therapy. URL: http://www.clinicaltrials.gov. Unique identifier: NCT02599259. © 2017 American Heart Association, Inc.

The future of the artificial kidney: moving towards wearable and miniaturized devices.

PubMed

Ronco, C; Davenport, A; Gura, V

2011-01-01

New directions in dialysis research include cheaper treatments, home based therapies and simpler methods of blood purification. These objectives may be probably obtained with innovations in the field of artificial kidney through the utilization of new disciplines such as miniaturization, microfluidics, nanotechnology. This research may lead to a new era of dialysis in which the new challenges are transportability, wearability and why not the possibility to develop implantable devices. Although we are not there yet, a new series of papers have recently been published disclosing interesting and promising results on the application of wearable ultrafiltration systems (WUF) and wearable artificial kidneys (WAK). Some of them use extracorporeal blood cleansing as a method of blood purification while others use peritoneal dialysis as a treatment modality (ViWAK and AWAK.) A special mention deserves the wearable/portable ultrafiltration system for the therapy of overhydration and congestive heart failure (WAKMAN). This system will allow dehospitalization and treatment of patients with less comorbidity and improved tolerance. On the way to the wearable artificial kidney, new discoveries have been made such as a complete system for hemofiltration in newborns (CARPEDIEM). The neonate in fact is the typical patient who may benefit from miniaturization of the dialysis circuit. This review analyzes the rationale for such endeavour and the challenges to overcome in order to make possible a true ambulatory dialysis treatment. Some initial results with these new devices are presented. We would like to stimulate a collaborative effort to make a quantum leap in technology making the wearable artificial kidney a reality rather than a dream. 

The algorithm study for using the back propagation neural network in CT image segmentation

NASA Astrophysics Data System (ADS)

Zhang, Peng; Liu, Jie; Chen, Chen; Li, Ying Qi

2017-01-01

Back propagation neural network(BP neural network) is a type of multi-layer feed forward network which spread positively, while the error spread backwardly. Since BP network has advantages in learning and storing the mapping between a large number of input and output layers without complex mathematical equations to describe the mapping relationship, it is most widely used. BP can iteratively compute the weight coefficients and thresholds of the network based on the training and back propagation of samples, which can minimize the error sum of squares of the network. Since the boundary of the computed tomography (CT) heart images is usually discontinuous, and it exist large changes in the volume and boundary of heart images, The conventional segmentation such as region growing and watershed algorithm can't achieve satisfactory results. Meanwhile, there are large differences between the diastolic and systolic images. The conventional methods can't accurately classify the two cases. In this paper, we introduced BP to handle the segmentation of heart images. We segmented a large amount of CT images artificially to obtain the samples, and the BP network was trained based on these samples. To acquire the appropriate BP network for the segmentation of heart images, we normalized the heart images, and extract the gray-level information of the heart. Then the boundary of the images was input into the network to compare the differences between the theoretical output and the actual output, and we reinput the errors into the BP network to modify the weight coefficients of layers. Through a large amount of training, the BP network tend to be stable, and the weight coefficients of layers can be determined, which means the relationship between the CT images and the boundary of heart.

Non-contact estimation of heart rate and oxygen saturation using ambient light.

PubMed

Bal, Ufuk

2015-01-01

We propose a robust method for automated computation of heart rate (HR) from digital color video recordings of the human face. In order to extract photoplethysmographic signals, two orthogonal vectors of RGB color space are used. We used a dual tree complex wavelet transform based denoising algorithm to reduce artifacts (e.g. artificial lighting, movement, etc.). Most of the previous work on skin color based HR estimation performed experiments with healthy volunteers and focused to solve motion artifacts. In addition to healthy volunteers we performed experiments with child patients in pediatric intensive care units. In order to investigate the possible factors that affect the non-contact HR monitoring in a clinical environment, we studied the relation between hemoglobin levels and HR estimation errors. Low hemoglobin causes underestimation of HR. Nevertheless, we conclude that our method can provide acceptable accuracy to estimate mean HR of patients in a clinical environment, where the measurements can be performed remotely. In addition to mean heart rate estimation, we performed experiments to estimate oxygen saturation. We observed strong correlations between our SpO2 estimations and the commercial oximeter readings.

Non-contact estimation of heart rate and oxygen saturation using ambient light

PubMed Central

Bal, Ufuk

2014-01-01

We propose a robust method for automated computation of heart rate (HR) from digital color video recordings of the human face. In order to extract photoplethysmographic signals, two orthogonal vectors of RGB color space are used. We used a dual tree complex wavelet transform based denoising algorithm to reduce artifacts (e.g. artificial lighting, movement, etc.). Most of the previous work on skin color based HR estimation performed experiments with healthy volunteers and focused to solve motion artifacts. In addition to healthy volunteers we performed experiments with child patients in pediatric intensive care units. In order to investigate the possible factors that affect the non-contact HR monitoring in a clinical environment, we studied the relation between hemoglobin levels and HR estimation errors. Low hemoglobin causes underestimation of HR. Nevertheless, we conclude that our method can provide acceptable accuracy to estimate mean HR of patients in a clinical environment, where the measurements can be performed remotely. In addition to mean heart rate estimation, we performed experiments to estimate oxygen saturation. We observed strong correlations between our SpO2 estimations and the commercial oximeter readings PMID:25657877

Chronic Heart Failure Follow-up Management Based on Agent Technology.

PubMed

Mohammadzadeh, Niloofar; Safdari, Reza

2015-10-01

Monitoring heart failure patients through continues assessment of sign and symptoms by information technology tools lead to large reduction in re-hospitalization. Agent technology is one of the strongest artificial intelligence areas; therefore, it can be expected to facilitate, accelerate, and improve health services especially in home care and telemedicine. The aim of this article is to provide an agent-based model for chronic heart failure (CHF) follow-up management. This research was performed in 2013-2014 to determine appropriate scenarios and the data required to monitor and follow-up CHF patients, and then an agent-based model was designed. Agents in the proposed model perform the following tasks: medical data access, communication with other agents of the framework and intelligent data analysis, including medical data processing, reasoning, negotiation for decision-making, and learning capabilities. The proposed multi-agent system has ability to learn and thus improve itself. Implementation of this model with more and various interval times at a broader level could achieve better results. The proposed multi-agent system is no substitute for cardiologists, but it could assist them in decision-making.

Prologue: ventricular assist devices and total artificial hearts. A historical perspective.

PubMed

Frazier, O H

2003-02-01

In the 1960s, when LVADs and TAHs were introduced into clinical use, researchers estimated that, with this technology, the problem of heart failure could be solved within 20 years. Unfortunately, the evolution of these devices has taken much longer than anticipated. Nevertheless, significant advances have been achieved in both cardiac assistance and replacement, and today's cardiac surgeons have a wide range of devices from which to choose (Table 4). This progress has largely been due to the support of the NHLBI, especially the Devices and Technology Division headed by John Watson, and of the devoted commitment of the investigators. Because of the long-term commitment required for both basic and clinical research, commercial medical technology companies are unable to assume this burden. Advances in mechanical circulatory support and replacement have benefited numerous patients worldwide who would otherwise have died of heart failure, and devices now exist for use as bridges to recovery, bridges to transplant, and destination therapy. The current challenge is to refine what we have and to apply these technologies to broader patient populations with maximal safety and at a reasonable cost.

Numerical investigation on effect of aortic root geometry on flow induced structural stresses developed in a bileaflet mechanical heart valve

NASA Astrophysics Data System (ADS)

Abbas, S. S.; Nasif, M. S.; Said, M. A. M.; Kadhim, S. K.

2017-10-01

Structural stresses developed in an artificial bileaflet mechanical heart valve (BMHV) due to pulsed blood flow may cause valve failure due to yielding. In this paper, von-Mises stresses are computed and compared for BMHV placed in two types of aortic root geometries that are aortic root with axisymmetric sinuses and with axisymmetric bulb, at different physiological blood flow rates. With BMHV placed in an aortic root with axisymmetric sinuses, the von-Mises stresses developed in the valve were found to be up to 47% higher than BMHV placed in aortic root with axisymmetric bulb under similar physiological conditions. High velocity vectors and therefore high von-Mises stresses have been observed for BMHV placed in aortic root with axisymmetric sinuses, that can lead to valve failure.

Gene and cell-based therapies for heart disease.

PubMed

Melo, Luis G; Pachori, Alok S; Kong, Deling; Gnecchi, Massimiliano; Wang, Kai; Pratt, Richard E; Dzau, Victor J

2004-04-01

Heart disease remains the prevalent cause of premature death and accounts for a significant proportion of all hospital admissions. Recent developments in understanding the molecular mechanisms of myocardial disease have led to the identification of new therapeutic targets, and the availability of vectors with enhanced myocardial tropism offers the opportunity for the design of gene therapies for both protection and rescue of the myocardium. Genetic therapies have been devised to treat complex diseases such as myocardial ischemia, heart failure, and inherited myopathies in various animal models. Some of these experimental therapies have made a successful transition to clinical trial and are being considered for use in human patients. The recent isolation of endothelial and cardiomyocyte precursor cells from adult bone marrow may permit the design of strategies for repair of the damaged heart. Cell-based therapies may have potential application in neovascularization and regeneration of ischemic and infarcted myocardium, in blood vessel reconstruction, and in bioengineering of artificial organs and prostheses. We expect that advances in the field will lead to the development of safer and more efficient vectors. The advent of genomic screening technology should allow the identification of novel therapeutic targets and facilitate the detection of disease-causing polymorphisms that may lead to the design of individualized gene and cell-based therapies.

Constraints and heroes.

PubMed

Elliott, Carl

1992-01-01

A story, perhaps apocryphal, is told about the United States surgical team which pioneered the first artificial heart procedure. It is said that the team received a number of telephone calls from people around the country who, worried about the ailing heart recipient, offered to donate to him their own hearts. When the surgical team, justifiably curious, sent psychiatrists to examine these donors, they found to their surprise that many of the donors were rational, competent, sincere, and fully aware that as a consequence of donating their hearts they would die.... My concerns here will be threefold. First, I want to add some substance to the widely-held intuition that there is something morally objectionable about a physician participating in procedures which put even a willing subject at risk. In so doing, I want to explore the larger question of why such a puzzle arises -- why physicians, and many others, find it morally objectionable to help someone do something which all agree to be heroic. Finally, I will start by examining some ways of framing the issue, widely employed in medical ethics, which I believe are simply wrong. This sort of puzzle is much more interesting than proponents of these standard arguments would have us believe, and it illustrates some larger points about morality which are often overlooked.

Intelligent postoperative morbidity prediction of heart disease using artificial intelligence techniques.

PubMed

Hsieh, Nan-Chen; Hung, Lun-Ping; Shih, Chun-Che; Keh, Huan-Chao; Chan, Chien-Hui

2012-06-01

Endovascular aneurysm repair (EVAR) is an advanced minimally invasive surgical technology that is helpful for reducing patients' recovery time, postoperative morbidity and mortality. This study proposes an ensemble model to predict postoperative morbidity after EVAR. The ensemble model was developed using a training set of consecutive patients who underwent EVAR between 2000 and 2009. All data required for prediction modeling, including patient demographics, preoperative, co-morbidities, and complication as outcome variables, was collected prospectively and entered into a clinical database. A discretization approach was used to categorize numerical values into informative feature space. Then, the Bayesian network (BN), artificial neural network (ANN), and support vector machine (SVM) were adopted as base models, and stacking combined multiple models. The research outcomes consisted of an ensemble model to predict postoperative morbidity after EVAR, the occurrence of postoperative complications prospectively recorded, and the causal effect knowledge by BNs with Markov blanket concept.

Using a Calculated Pulse Rate with an Artificial Neural Network to Detect Irregular Interbeats.

PubMed

Yeh, Bih-Chyun; Lin, Wen-Piao

2016-03-01

Heart rate is an important clinical measure that is often used in pathological diagnosis and prognosis. Valid detection of irregular heartbeats is crucial in the clinical practice. We propose an artificial neural network using the calculated pulse rate to detect irregular interbeats. The proposed system measures the calculated pulse rate to determine an "irregular interbeat on" or "irregular interbeat off" event. If an irregular interbeat is detected, the proposed system produces a danger warning, which is helpful for clinicians. If a non-irregular interbeat is detected, the proposed system displays the calculated pulse rate. We include a flow chart of the proposed software. In an experiment, we measure the calculated pulse rates and achieve an error percentage of < 3% in 20 participants with a wide age range. When we use the calculated pulse rates to detect irregular interbeats, we find such irregular interbeats in eight participants.

A simple numerical model for membrane oxygenation of an artificial lung machine

NASA Astrophysics Data System (ADS)

Subraveti, Sai Nikhil; Sai, P. S. T.; Viswanathan Pillai, Vinod Kumar; Patnaik, B. S. V.

2015-11-01

Optimal design of membrane oxygenators will have far reaching ramification in the development of artificial heart-lung systems. In the present CFD study, we simulate the gas exchange between the venous blood and air that passes through the hollow fiber membranes on a benchmark device. The gas exchange between the tube side fluid and the shell side venous liquid is modeled by solving mass, momentum conservation equations. The fiber bundle was modelled as a porous block with a bundle porosity of 0.6. The resistance offered by the fiber bundle was estimated by the standard Ergun correlation. The present numerical simulations are validated against available benchmark data. The effect of bundle porosity, bundle size, Reynolds number, non-Newtonian constitutive relation, upstream velocity distribution etc. on the pressure drop, oxygen saturation levels etc. are investigated. To emulate the features of gas transfer past the alveoli, the effect of pulsatility on the membrane oxygenation is also investigated.

Designing It Smart With SIV

NASA Technical Reports Server (NTRS)

2003-01-01

When research staff at NASA s Glenn Research Center developed and patented Stereo Imaging Velocimetry (SIV), the world s first three-dimensional (3-D), full-field quantitative and qualitative analysis tool to investigate flow velocities, experiments that were previously impossible became a reality. Seizing the opportunity to commercialize NASA s breakthrough invention, Digital Interface Systems (DIS), Inc., of North Olmsted, Ohio, acquired an exclusive license to market SIV, which has a range of applications from improving the aerodynamics of aircraft and automobiles to avoiding "no flow" regions in artificial hearts.

Do those who cannot speak really have a voice?

PubMed

Dew, Betty

1992-01-01

Joseph Finelli, after a heart transplant, is being artificially maintained by medications and a gastrostomy tube (G-tube). He is not brain dead nor in a persistent vegetative state. In my role as court-appointed Guardian ad Litem (GAL-court investigator), it appears to me that Mr. Finelli is being treated against his stated goals and values. After applying the substituted judgment factors, I recommend the withdrawal of the medication which sustains his life. His family adamantly opposes my position.

Management and design of long-life systems; Proceedings of the Symposium, Denver, Colo., April 24-26, 1973

NASA Technical Reports Server (NTRS)

Schurmeier, H. M.

1974-01-01

The long life of Pioneer interplanetary spacecraft is considered along with a general accelerated methodology for long-life mechanical components, dependable long-lived household appliances, and the design and development philosophy to achieve reliability and long life in large turbine generators. Other topics discussed include an integrated management approach to long life in space, artificial heart reliability factors, and architectural concepts and redundancy techniques in fault-tolerant computers. Individual items are announced in this issue.

Not so Sweet Revenge: Unanticipated Consequences of High-Intensity Sweeteners.

PubMed

Swithers, Susan E

2015-05-01

While no single factor accounts for the significant increases in overweight and obesity that have emerged during the past several decades, evidence now suggests that sugars, in general, and sugar-sweetened beverages, in particular, may be especially problematic. One response to this concern has been an explosion in the availability and use of noncaloric sweeteners as replacements for sugar. While consumers have been led to believe that such substitutes are healthy, long-term epidemiological data in a number of cohorts have documented increased risk for negative outcomes like type 2 diabetes, heart disease, and stroke among users of artificial sweeteners. Experimental data from animals has provided several plausible mechanisms that could explain this counterintuitive relationship. In particular, my research has demonstrated that artificial sweeteners appear to interfere with basic learned, predictive relations between sweet tastes and post-ingestive consequences such as the delivery of energy. By interfering with these relations, artificial sweeteners inhibit anticipatory responses that normally serve to maintain physiological homeostasis, and over the long term, this interference could result in negative health effects like those seen in the human cohort studies. These data suggest that reducing the consumption of all sweeteners is advisable to promote better health.

Experimental assessment of valve performance in healthy and diseased right ventricular outflow tracts using magnetic resonance velocimetry

NASA Astrophysics Data System (ADS)

Schiavone, Nicole; Elkins, Christopher; McElhinney, Doff; Eaton, John K.; Marsden, Alison

2017-11-01

Tetralogy of Fallot (ToF), the most common type of cyanotic congenital heart defect, affects 1 in every 2500 newborns annually and typically requires surgical repair of the right ventricular outflow tract (RVOT) and placement of an artificial pulmonary valve. All artificial valves are subject to dysfunction, but their longevity is highly variable. Clinical observation reveals large variations in RVOT anatomy in ToF patients, which may affect longevity. This work aims to experimentally assess the performance of artificial pulmonary valves in anatomically realistic healthy and diseased RVOT geometries using magnetic resonance velocimetry (MRV). With MRV, we can capture 3D, three-component, phase-averaged velocity fields in 3D printed RVOT geometries. The experiment is designed to ensure physiological flow rate and pressure waveforms, while the RVOT geometries are based on anatomies seen clinically in ToF patients. Two models are used in the current work: an idealized RVOT based on healthy subjects aged eleven to thirteen and a diseased geometry with a dilation of 150% in vessel diameter downstream of the pulmonary valve. We will also present preliminary rigid-wall blood flow simulations in each model, towards the ultimate goal of experimental validation of valve simulations.

Frequent Consumption of Sugar- and Artificially Sweetened Beverages and Natural and Bottled Fruit Juices Is Associated with an Increased Risk of Metabolic Syndrome in a Mediterranean Population at High Cardiovascular Disease Risk.

PubMed

Ferreira-Pêgo, Cíntia; Babio, Nancy; Bes-Rastrollo, Maira; Corella, Dolores; Estruch, Ramon; Ros, Emilio; Fitó, Montserrat; Serra-Majem, Lluís; Arós, Fernando; Fiol, Miguel; Santos-Lozano, José Manuel; Muñoz-Bravo, Carlos; Pintó, Xavier; Ruiz-Canela, Miguel; Salas-Salvadó, Jordi

2016-08-01

The relation between the consumption of sweetened beverages and metabolic syndrome (MetS) is controversial. This analysis evaluated the associations between intakes of sugar-sweetened beverages (SSBs), artificially sweetened beverages, and natural and bottled fruit juices and the incidence of MetS in elderly individuals at high risk of cardiovascular disease (CVD) and without MetS at baseline. We prospectively examined 1868 participants free of MetS at baseline from the PREDIMED (PREvención con DIeta MEDiterránea) study. MetS was defined by using the updated harmonized criteria of the International Diabetes Federation, the American Heart Association, and National Heart, Lung, and Blood Institute. Energy and nutrient intakes were evaluated at baseline and then yearly by using a validated 137-item food-frequency questionnaire. Multivariable-adjusted HRs for MetS and its components were estimated from mean intakes during follow-up. We compared the 2 highest consumption categories (1-5 and >5 servings/wk) with the lowest category (<1 serving/wk). A total of 930 incident cases of MetS were documented during a median follow-up of 3.24 y. When we compared consumption of >5 servings/wk with consumption of <1 serving/wk, multivariable HRs (95% CIs) for MetS incidence were 1.43 (1.00, 2.15), 1.74 (1.26, 2.41), 1.30 (1.00, 1.69), and 1.14 (1.04, 1.65) for SSBs, artificially sweetened beverages, natural fruit juices, and bottled fruit juices, respectively. The occasional consumption of SSBs and artificially sweetened beverages (1-5 servings/wk) was not associated with the incidence of MetS in middle-aged and elderly individuals at high risk of CVD. The consumption of >5 servings/wk of all of the types of beverages analyzed was associated with an increased risk of MetS and some of its components. However, for SSBs and bottled fruit juices these associations must be interpreted with caution because of the low frequency of consumption in this population. This trial was registered at clinicaltrials.gov as ISRCTN35739639. © 2016 American Society for Nutrition.

Does Consuming Sugar and Artificial Sweeteners Change Taste Preferences?

PubMed Central

Bartolotto, Carole

2015-01-01

Americans consume a lot of sugar, primarily from sweeteners that are added to processed foods and beverages. Data from the US Department of Agriculture reveals that in 2013, Americans consumed 22.3 teaspoons of added caloric sweeteners a day, which is significantly more than the American Heart Association’s recommendation. Artificial and alternative sweeteners have also been added to a plethora of foods. These sweeteners range from about 180 times sweeter to as much as 13,000 times sweeter than sugar. Consumption of both sugar and artificial sweeteners may be changing our palates or taste preferences over time, increasing our desire for sweet foods. Unfortunately, the data on this are lacking. In the summer of 2014, a group of 20 people from Kaiser Permanente facilities throughout California agreed to cut out all added sugars and artificial sweeteners for 2 weeks and then complete a survey to determine whether their taste preferences had changed. After the 2-week challenge, 95% of participants (18 out of 19 respondents) found that sweet foods and drinks tasted sweeter or too sweet, 75% (15 out of 20 respondents) found that other foods tasted sweeter, and 95% (19 out of 20 respondents) said moving forward they would use less or even no sugar. Additionally, 86.6% of participants (13 out of 15 respondents) stopped craving sugar after 6 days. Although this was a small survey, the results suggest that using a 2-week sugar challenge can help to reset taste preferences and make consuming less or no sugar easier. Physicians should consider recommending a sugar and artificial sweetener challenge to all their patients, especially those with obesity, diabetes, or cardiovascular disease. PMID:26176574

Sugar- and artificially-sweetened beverages and the risks of incident stroke and dementia: A prospective cohort study

PubMed Central

Pase, Matthew P.; Himali, Jayandra J.; Beiser, Alexa S.; Aparicio, Hugo J.; Satizabal, Claudia L.; Vasan, Ramachandran S.; Seshadri, Sudha; Jacques, Paul F.

2017-01-01

Background and purpose Sugar- and artificially-sweetened beverage intake have been linked to cardiometabolic risk factors, which increase the risk of cerebrovascular disease and dementia. We examined whether sugar- or artificially-sweetened beverage consumption were associated with the prospective risks of incident stroke or dementia in the community-based Framingham Heart Study Offspring cohort. Methods We studied 2888 participants aged over 45 for incident stroke (mean age 62 [SD, 9] years; 45% men) and 1484 participants aged over 60 for incident dementia (mean age 69 [SD, 6] years; 46% men). Beverage intake was quantified using a food frequency questionnaire at cohort examinations 5 (1991–1995), 6 (1995–1998) and 7 (1998–2001). We quantified recent consumption at examination 7 and cumulative consumption by averaging across examinations. Surveillance for incident events commenced at examination 7 and continued for 10-years. We observed 97 cases of incident stroke (82 ischemic) and 81 cases of incident dementia (63 consistent with Alzheimer’s disease [AD]). Results After adjustments for age, sex, education (for analysis of dementia), caloric intake, diet quality, physical activity and smoking, higher recent and higher cumulative intake of artificially-sweetened soft drinks were associated with an increased risk of ischemic stroke, all-cause dementia, and AD dementia. When comparing daily cumulative intake to <1 per week (reference), the hazard ratios were 2.96 (95% CI, 1.26–6.97) for ischemic stroke and 2.89 (95% CI, 1.18–7.07) for AD. Sugar-sweetened beverages were not associated with stroke or dementia. Conclusions Artificially-sweetened soft drink consumption was associated with a higher risk of stroke and dementia. PMID:28428346

Systematic review and meta-analysis of studies of the timing of tracheostomy in adult patients undergoing artificial ventilation

PubMed Central

Griffiths, John; Barber, Vicki S; Morgan, Lesley; Young, J Duncan

2005-01-01

Objective To compare outcomes in critically ill patients undergoing artificial ventilation who received a tracheostomy early or late in their treatment. Data sources The Cochrane Central Register of Clinical Trials, Medline, Embase, CINAHL, the National Research Register, the NHS Trusts Clinical Trials Register, the Medical Research Council UK database, the NHS Research and Development Health Technology Assessment Programme, the British Heart Foundation database, citation review of relevant primary and review articles, and expert informants. Study selection Randomised and quasi-randomised controlled studies that compared early tracheostomy with either late tracheostomy or prolonged endotracheal intubation. From 15 950 articles screened, 12 were identified as “randomised or quasi-randomised” controlled trials, and five were included for data extraction. Data extraction Five studies with 406 participants were analysed. Descriptive and outcome data were extracted. The main outcome measure was mortality in hospital. The incidence of hospital acquired pneumonia, length of stay in a critical care unit, and duration of artificial ventilation were also recorded. Random effects meta-analyses were performed. Results Early tracheostomy did not significantly alter mortality (relative risk 0.79, 95% confidence interval 0.45 to 1.39). The risk of pneumonia was also unaltered by the timing of tracheostomy (0.90, 0.66 to 1.21). Early tracheostomy significantly reduced duration of artificial ventilation (weighted mean difference –8.5 days, 95% confidence interval –15.3 to –1.7) and length of stay in intensive care (–15.3 days, –24.6 to –6.1). Conclusions In critically ill adult patients who require prolonged mechanical ventilation, performing a tracheostomy at an earlier stage than is currently practised may shorten the duration of artificial ventilation and length of stay in intensive care. PMID:15901643

Heart rate informed artificial pancreas system enhances glycemic control during exercise in adolescents with T1D.

PubMed

DeBoer, Mark D; Cherñavvsky, Daniel R; Topchyan, Katarina; Kovatchev, Boris P; Francis, Gary L; Breton, Marc D

2017-11-01

To evaluate the safety and performance of using a heart rate (HR) monitor to inform an artificial pancreas (AP) system during exercise among adolescents with type 1 diabetes (T1D). In a randomized, cross-over trial, adolescents with T1D age 13 - 18 years were enrolled to receive on separate days either the unmodified UVa AP (stdAP) or an AP system connected to a portable HR monitor (AP-HR) that triggered an exercise algorithm for blood glucose (BG) control. During admissions participants underwent a structured exercise regimen. Hypoglycemic events and CGM tracings were compared between the two admissions, during exercise and for the full 24-hour period. Eighteen participants completed the trial. While number of hypoglycemic events during exercise and rest was not different between visits (0.39 AP-HR vs 0.50 stdAP), time below 70 mg dL -1 was lower on AP-HR compared to stdAP, 0.5±2.1% vs 7.4±12.5% (P = 0.028). Time with BG within 70-180 mg dL -1 was higher for the AP-HR admission vs stdAP during the exercise portion and overall (96% vs 87%, and 77% vs 74%), but these did not reach statistical significance (P = 0.075 and P = 0.366). Heart rate signals can safely and efficaciously be integrated in a wireless AP system to inform of physical activity. While exercise contributes to hypoglycemia among adolescents, even when using an AP system, informing the system of exercise via a HR monitor improved time <70 mg dL -1 . Nonetheless, it did not significantly reduce the total number of hypoglycemic events, which were low in both groups. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Bridge to transplantation using paracorporeal biventricular assist devices or the syncardia temporary total artificial heart: is there a difference?

PubMed

Nguyen, A; Pozzi, M; Mastroianni, C; Léger, P; Loisance, D; Pavie, A; Leprince, P; Kirsch, M

2015-06-01

Biventricular support can be achieved using paracorporeal ventricular assist devices (p-BiVAD) or the Syncardia temporary total artificial heart (t-TAH). The purpose of the present study was to compare survival and morbidity between these devices. Data from 2 French neighboring hospitals were reviewed. Between 1996 and 2009, 148 patients (67 p-BiVADs and 81 t-TAH) underwent primary, planned biventricular support. There were 128 (86%) males aged 44±13 years. Preoperatively, p-BiVAD recipients had significantly lower systolic and diastolic blood pressures, more severe hepatic cytolysis and higher white blood cell counts than t-TAH recipients. In contrast, t-TAH patients had significantly higher rates of pre-implant ECLS and hemofiltration. Mean support duration was 79±100 days for the p-BiVAD group and 71±92 for t-TAH group (P=0.6). Forty two (63%) p-BiVAD recipients were bridged to transplantation (39, 58%) or recovery (3, 5%), whereas 51 (63%) patients underwent transplantation in the t-TAH group. Death on support was similar between groups (p-BiVAD, 26 (39%); t-TAH, 30 (37%); P=0.87). Survival while on device was not significantly different between patient groups and multivariate analysis showed that only preimplant diastolic blood pressure and alanine amino-transferase levels were significant predictors of death. Post-transplant survival in the p-BiVAD group was 76±7%, 70±8%, and 58±9% at 1, 3, and 5 years after transplantation, respectively, and was similar to that of the t-TAH group (77±6%, 72±6%, and 70±7%, P=0.60). Survival while on support and up to 5 years after heart transplantation was not significantly different in patients supported by p-BiVADs or t-TAH. Multivariate analysis revealed that survival while on transplantation was not affected by the type of device implanted.

Exercise Increases the Cardiovascular Stimulus Provided by Artificial Gravity

NASA Technical Reports Server (NTRS)

Howarth, M. S.; Moore, F. B.; Hinghofer-Szalkay, H.; Jezova, D.; Diedrich, A.; Ferris, M. B.; Schlegel, T. T.; Pathwardhan, A. R.; Knapp, C. F.; Evans, J. M.

2008-01-01

We investigated fluid shifts and regulatory responses to variations of posture, exercise, Gz level and radius of rotation in subjects riding NASA Ames 20G centrifuge. Results are from 4 protocols that address radius and exercise effects only. Protocol A: After 10 min supine control, 12 healthy men (35 plus or minus 9 yr, 82.8 plus or minus 7.9 kg) were exposed to rotational 1 Gz (2.5 m radius) for 2 min followed by 20 min alternating between 1 and 1.25 Gz. Blood samples were taken pre and post spin. Protocol B: Same as A, but lower limb exercise (70% V02max) preceded ramps to 1.25 Gz. Protocol C: Same as A but radius of rotation 8.3 m. Protocol D: Same as B but at 8.3 m. The 8 subjects who completed all protocols, increased heart rate (HR) from control, on average, by: A: 5, B: 39, C: 11, D: 44 bpm. For thoracic fluid volume, (bioimpedance), the 8 subjects changed from control, on average: A: -394, B: -548, C: -537, D: -708 mL. For thigh fluid volume, changes from control, on average, were: A: -137, B: 129, C: -75, D: 159 mL. Hematocrit changes from control were: A: 2.3, B: 3.5, C: 2.3, D: 4.3 %. Radius effects were mild and included greater loss of fluid from the thorax, less fluid loss from the thigh and increased heart rate at the longer radius. Pre-acceleration exercise effects were more dramatic and included additional loss of fluid from the chest, increased fluid volume of the thigh, increased hematocrit and greater heart rate increases. We propose that short bouts of intense exercise can be used to magnify the cardiovascular stress delivered by artificial gravity (AG) training and the combination of AG with exercise training can be fine-tuned to preserve orthostatic tolerance of astronauts during spaceflight.

Development of mechanical circulatory support devices in China.

PubMed

Wang, Wei; Zhu, De-Ming; Ding, Wen-Xiang

2009-11-01

Myocardial dysfunction leading to low cardiac output syndrome is a common clinical pathophysiological state. Currently, the use of mechanical circulatory support (MCS) is an essential aspect of the treatment of patients with cardiac failure. Several groups in China are engaged in the design and development of MCS devices. These devices can be classified as pulsatile, rotary, and total artificial heart (TAH). There are two types of pulsatile pump, which are driven by air (pneumatic). One of these pumps, the Luo-Ye pump, has been used clinically for short-term support since 1998. The other is a push-plate left ventricular device, which has a variable rate mode. Various rotary devices are classified into axial and centrifugal pumps, depending on the impeller geometry. Most rotary pumps are based on the maglev principle, and some types have been used clinically. Others are still being studied in the laboratory or in animal experiments. Furthermore, certain types of total implantable pump, such as the UJS-III axial pump and the UJS-IV aortic valvo-pump, have been developed. Only one type of TAH has been developed in China. The main constituents of this artificial heart are two axial pumps, two reservoir tanks mimicking the right and left atria, flow meters, two pressure gauges, and a resistance adaptor. Although the development of mechanical assist devices in China is still in a nascent stage, a number of different types of MCS devices are currently being studied.

The Carmat Bioprosthetic Total Artificial Heart Is Associated With Early Hemostatic Recovery and no Acquired von Willebrand Syndrome in Calves.

PubMed

Smadja, David M; Susen, Sophie; Rauch, Antoine; Cholley, Bernard; Latrémouille, Christian; Duveau, Daniel; Zilberstein, Luca; Méléard, Denis; Boughenou, Marie-Fazia; Belle, Eric Van; Gaussem, Pascale; Capel, Antoine; Jansen, Piet; Carpentier, Alain

2017-10-01

To determine hemostasis perturbations, including von Willebrand factor (VWF) multimers, after implantation of a new bioprosthetic and pulsatile total artificial heart (TAH). Preclinical study SETTING: Single-center biosurgical research laboratory. Female Charolais calves, 2-to-6 months old, weighing 102-to-122 kg. Surgical implantation of TAH through a mid-sternotomy approach. Four of 12 calves had a support duration of several days (4, 4, 8, and 10 days), allowing for the exploration of early steps of hemostasis parameters, including prothrombin time; coagulation factor levels (II, V, VII+X, and fibrinogen); and platelet count. Multimeric analysis of VWF was performed to detect a potential loss of high-molecular weight (HMW) multimers, as previously described for continuous flow rotary blood pumps. Despite the absence of anticoagulant treatment administered in the postoperative phase, no signs of coagulation activation were detected. Indeed, after an immediate postsurgery decrease of prothrombin time, platelet count, and coagulation factor levels, most parameters returned to baseline values. HMW multimers of VWF remained stable either after initiation or during days of support. Coagulation parameters and platelet count recovery in the postoperative phase of the Carmat TAH (Camat SA, Velizy Villacoublay Cedex, France) implantation in calves, in the absence of anticoagulant treatment and associated with the absence of decrease in HMW multimers of VWF, is in line with early hemocompatibility that is currently being validated in human clinical studies. Copyright © 2017 Elsevier Inc. All rights reserved.

Application of Adaptive Starling-Like Controller to Total Artificial Heart Using Dual Rotary Blood Pumps.

PubMed

Ng, Boon C; Smith, Peter A; Nestler, Frank; Timms, Daniel; Cohn, William E; Lim, Einly

2017-03-01

The successful clinical applicability of rotary left ventricular assist devices (LVADs) has led to research interest in devising a total artificial heart (TAH) using two rotary blood pumps (RBPs). The major challenge when using two separately controlled LVADs for TAH support is the difficulty in maintaining the balance between pulmonary and systemic blood flows. In this study, a starling-like controller (SLC) hybridized with an adaptive mechanism was developed for a dual rotary LVAD TAH. The incorporation of the adaptive mechanism was intended not only to minimize the risk of pulmonary congestion and atrial suction but also to match cardiac demand. A comparative assessment was performed between the proposed adaptive starling-like controller (A-SLC) and a conventional SLC as well as a constant speed controller. The performance of all controllers was evaluated by subjecting them to three simulated scenarios [rest, exercise, head up tilt (HUT)] using a mock circulation loop. The overall results showed that A-SLC was superior in matching pump flow to cardiac demand without causing hemodynamic instabilities. In contrast, improper flow regulation by the SLC resulted in pulmonary congestion during exercise. From resting supine to HUT, overpumping of the RBPs at fixed speed (FS) caused atrial suction, whereas implementation of SLC resulted in insufficient flow. The comparative study signified the potential of the proposed A-SLC for future TAH implementation particularly among outpatients, who are susceptible to variety of clinical scenarios.

Estimated flows of gases and carbon within CEEF ecosystem composed of human, crops and goats

NASA Astrophysics Data System (ADS)

Tako, Y.; Komatsubara, O.; Honda, G.; Arai, R.; Nitta, K.

The Closed Ecology Experiment Facilities (CEEF) can be used as a test bed for Controlled Ecological Life Support Systems (CELSS), because technologies developed for the CEEF system facilitate self-sufficient material circulation necessary for long term missions such as Lunar and Mars exploration. In the experiment conducted under closed condition in FY2003, rice and soybeans were cultivated sequentially in two chambers and a chamber, each having a cultivation area of 30 m2 and floor area of 43 m2, inside the Plantation Module with artificial lighting of the CEEF. In the chamber having a cultivation area of 60 m2 and floor area of 65 m2, inside the Plantation Module with natural and artificial lighting, peanuts and safflowers were also cultivated. Stable transplant (or seeding) and harvest of each crop were maintained during a month. Flows of CO2, O2 and carbon to and from the crops were analyzed during the stable cultivation period. Simulated works and stay in the CEEF lasting five days were conducted two times under ventilating condition in FY2003. Gas exchange of human was estimated using heart rate data collected during the experiments and correlation between gas exchange rate and heart rate. Gas exchange rate and carbon balance of female goats were determined using an open-flow measurement system with a gastight chamber. From these results, flows of gases and carbon in the CEEF were discussed.

Silencing Genes in the Heart.

PubMed

Fechner, Henry; Vetter, Roland; Kurreck, Jens; Poller, Wolfgang

2017-01-01

Silencing of cardiac genes by RNA interference (RNAi) has developed into a powerful new method to treat cardiac diseases. Small interfering (si)RNAs are the inducers of RNAi, but cultured primary cardiomyocytes and heart are highly resistant to siRNA transfection. This can be overcome by delivery of small hairpin (sh)RNAs or artificial microRNA (amiRNAs) by cardiotropic adeno-associated virus (AAV) vectors. Here we describe as example of the silencing of a cardiac gene, the generation and cloning of shRNA, and amiRNAs directed against the cardiac protein phospholamban. We further describe the generation of AAV shuttle plasmids with self complementary vector genomes, the production of AAV vectors in roller bottles, and their purification via iodixanol gradient centrifugation and concentration with filter systems. Finally we describe the preparation of primary neonatal rat cardiomyocytes (PNRC), the transduction of PNRC with AAV vectors, and the maintenance of the transduced cell culture.

Hemodynamic simulations in coronary aneurysms of a patient with Kawasaki Disease

NASA Astrophysics Data System (ADS)

Sengupta, Dibyendu; Marsden, Alison; Burns, Jane

2010-11-01

Kawasaki Disease is the leading cause of acquired pediatric heart disease, and can cause large coronary artery aneurysms in untreated cases. A simulation case study has been performed for a 10-year-old male patient with coronary aneurysms. Specialized coronary boundary conditions along with a lumped parameter heart model mimic the interactions between the ventricles and the coronary arteries, achieving physiologic pressure and flow waveforms. Results show persistent low shear stress in the aneurismal regions, and abnormally high shear at the aneurysm neck. Correlation functions have been derived to compare wall shear stress and wall shear stress gradients with recirculation time with the idea of localizing zones of calcification and thrombosis. Results are compared with those of an artificially created normal coronary geometry for the same patient. The long-term goal of this work is to develop links between hemodynamics and thrombotic risk to assist in clinical decision-making.

Mapping conduction velocity of early embryonic hearts with a robust fitting algorithm

PubMed Central

Gu, Shi; Wang, Yves T; Ma, Pei; Werdich, Andreas A; Rollins, Andrew M; Jenkins, Michael W

2015-01-01

Cardiac conduction maturation is an important and integral component of heart development. Optical mapping with voltage-sensitive dyes allows sensitive measurements of electrophysiological signals over the entire heart. However, accurate measurements of conduction velocity during early cardiac development is typically hindered by low signal-to-noise ratio (SNR) measurements of action potentials. Here, we present a novel image processing approach based on least squares optimizations, which enables high-resolution, low-noise conduction velocity mapping of smaller tubular hearts. First, the action potential trace measured at each pixel is fit to a curve consisting of two cumulative normal distribution functions. Then, the activation time at each pixel is determined based on the fit, and the spatial gradient of activation time is determined with a two-dimensional (2D) linear fit over a square-shaped window. The size of the window is adaptively enlarged until the gradients can be determined within a preset precision. Finally, the conduction velocity is calculated based on the activation time gradient, and further corrected for three-dimensional (3D) geometry that can be obtained by optical coherence tomography (OCT). We validated the approach using published activation potential traces based on computer simulations. We further validated the method by adding artificially generated noise to the signal to simulate various SNR conditions using a curved simulated image (digital phantom) that resembles a tubular heart. This method proved to be robust, even at very low SNR conditions (SNR = 2-5). We also established an empirical equation to estimate the maximum conduction velocity that can be accurately measured under different conditions (e.g. sampling rate, SNR, and pixel size). Finally, we demonstrated high-resolution conduction velocity maps of the quail embryonic heart at a looping stage of development. PMID:26114034

Minimally Invasive Implantation of HeartWare Assist Device and Simultaneous Tricuspid Valve Reconstruction Through Partial Upper Sternotomy.

PubMed

Hillebrand, Julia; Hoffmeier, Andreas; Djie Tiong Tjan, Tonny; Sindermann, Juergen R; Schmidt, Christoph; Martens, Sven; Scherer, Mirela

2017-05-01

Left ventricular assist device (LVAD) implantation is a well-established therapy to support patients with end-stage heart failure. However, the operative procedure is associated with severe trauma. Third generation LVADs like the HeartWare assist device (HeartWare, Inc., Framingham, MA, USA) are characterized by enhanced technology despite smaller size. These devices offer new minimally invasive surgical options. Tricuspid regurgitation requiring valve repair is frequent in patients with the need for mechanical circulatory support as it is strongly associated with ischemic and nonischemic cardiomyopathy. We report on HeartWare LVAD implantation and simultaneous tricuspid valve reconstruction through minimally invasive access by partial upper sternotomy to the fifth left intercostal space. Four male patients (mean age 51.72 ± 11.95 years) suffering from chronic heart failure due to dilative (three patients) and ischemic (one patient) cardiomyopathy and also exhibiting concomitant tricuspid valve insufficiency due to annular dilation underwent VAD implantation and tricuspid valve annuloplasty. Extracorporeal circulation was established via the ascending aorta, superior vena cava, and right atrium. In all four cases the LVAD implantation and tricuspid valve repair via partial median sternotomy was successful. During the operative procedure, no conversion to full sternotomy was necessary. One patient needed postoperative re-exploration because of pericardial effusion. No postoperative focal neurologic injury was observed. New generation VADs are advantageous because of the possibility of minimally invasive implantation procedure which can therefore minimize surgical trauma. Concomitant tricuspid valve reconstruction can also be performed simultaneously through partial upper sternotomy. Nevertheless, minimally invasive LVAD implantation is a challenging operative technique. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

US FDA perspective on regulatory issues affecting circulatory assist devices.

PubMed

Sapirstein, Wolf; Chen, Eric; Swain, Julie; Zuckerman, Bram

2006-11-01

There has been a rapid development in mechanical circulatory support systems in the decade since the US FDA first approved a mechanical device to provide the circulatory support lacking from a failing heart. Devices are presently approved for marketing by the FDA to replace a failing ventricle, the Ventricular Assist Device or the entire heart, Total Artificial Heart. Contemporaneous with, and permitted by, improvement in technology and design, devices have evolved from units located extracorporeally to paracorporeal systems and totally implanted devices. Clinical studies have demonstrated a parallel improvement in the homeostatic adequacy of the circulatory support provided. Thus, while the circulatory support was initially tolerated for short periods to permit recovery of cardiac function, this technology eventually provided effective circulatory support for increasing periods that permitted the FDA to approve devices for bridging patients in end-stage cardiac failure awaiting transplant and eventually a device for destination therapy where patients in end-stage heart failure are not cardiac transplant candidates. The approved devices have relied on displacement pumps that mimic the pulsatility of the physiological system. Accelerated development of more compact devices that rely on alternative pump mechanisms have challenged both the FDA and device manufacturers to assure that the regulatory requirements for safety and effectiveness are met for use of mechanical circulatory support systems in expanded target populations. An FDA regulatory perspective is reviewed of what can be a potentially critical healthcare issue.

Artificial rain and cold wind act as stressors to captive molting and non-molting European starlings (Sturnus vulgaris).

PubMed

de Bruijn, Robert; Romero, L Michael

2013-03-01

Free-roaming animals continually cope with changes in their environment. One of the most unpredictable environmental phenomena is weather. Being able to respond to weather appropriately is crucial as it can be a threat to survival. The stress response, consisting of increases in heart rate and release of glucocorticoids, is an important mechanism by which animals cope with stressors. This study examined behavioral, heart rate, and corticosterone responses of captive European starlings (Sturnus vulgaris) to two aspects of weather mimicked under controlled conditions, a subtle (3 °C) decrease in temperature and a short, mild bout of rain. Both decreased temperature and exposure to rain elicited increases in heart rate and corticosterone in non-molting starlings. Molt is an important life history stage in birds that affects feather cover and may require a different response to weather-related stressors. We repeated the experiment in molting starlings and found increases in heart rate in response to rain and cold wind. However, the hypothalamic-pituitary-adrenal (HPA)-axis was suppressed during molt, as molting starlings did not increase corticosterone release in response to either stimulus. These data suggest these stimuli induce increased allostatic load in starlings, and that animals may adjust their response depending on the life-history stage. Copyright © 2012 Elsevier Inc. All rights reserved.

[Optimal acupoint combination of transcutaneous electrical stimulation in artificial abortion operation].

PubMed

Chen, Chong; Xie, Wenxia; Wang, Zedong; Zeng, Linchai; Liu, Pei; Li, Chunli

2017-02-12

To observe the clinical effects on analgesia, tranquilization and prevention of abortion syndrome of artificial abortion operation treated with transcutaneous electrical acupoint stimulation (TEAS) with different acupoint combination and explore the optimal acupoint combination of TEAS in artificial abortion operation. Two hundred patients intended to artificial operation were randomized into No.1 group[Sanyinjiao (SP 6) + Zusanli (ST 36)], No.2 group[Sanyinjiao (SP 6) + Diji (SP 8)], No.3 group[Sanyinjiao (SP 6) + Taichong (LR 3)], No.4 group (cervical blockage anesthesia with lidocaine) and No.5 group (blank group, without any analgesia measure applied), 40 cases in each one. In the No.1, No.2 and No.3 groups, Sanyinjiao (SP 6) was the main acupoint, combined with Zusanli (ST 36), Dijin (SP 8) and Taichong (LR 3) respectively. TEAS was given 30 min before the operation till the end of operation. Mean arterial pressure, heart rate and oxygen saturation during operation, as well as bleeding amount were observed in the five groups. The visual analogue scale (VAS) score was observed during and 30 min after operation, and Ramsay score was observed during operation. Cervical relaxation degree and the incidence of artificial abortion syndrome were recorded. For VAS score during and 30 min after operation and Ramsay score during operation, the differences were significant statistically in the No. 1, No.2, No.3 and No.4 groups as compared with the No.5 group ( P <0.01, P <0.05). The results in the No.2 group were better than those in the No.1, No.3 and No.4 groups (all P <0.05). For cervical relaxationdegree, the result in the No.2 group was better than that in each of the rest groups ( P <0.01, P <0.05). For artificial abortion syndrome, the incidences in the No.2 and No.3 groups were lower than those in the No.4 and No.5 groups (all P <0.05). For bleeding amount and hemodynamic changes, the differences were not significant statistically among the five groups (all P >0.05). TEAS apparently reduces pain score during and 30 min after artificial abortion operation and achieves the satisfactory tranguilization effects. The combination of Sanyinjiao (SP 6) and Diji (SP 8) achieves the optimal effect of analgesia, tranquilization, dilating cervix and preventing from artificial abortion syndrome in the operation.

Comparison of total artificial heart and biventricular assist device support as bridge-to-transplantation.

PubMed

Cheng, Allen; Trivedi, Jaimin R; Van Berkel, Victor H; Massey, H Todd; Slaughter, Mark S

2016-10-01

The use of left ventricular assist devices (LVAD) has increased significantly in the last decade. However, right heart dysfunction remains a problem despite the improved outcomes with continuous-flow LVADs. Surgical options for bridge to transplantation (BTT) in patients with biventricular failure are total artificial heart (TAH) or biventricular support (BiVAD). This study examines the differences in pre- and post-transplantation outcomes and survival in patients with TAH or BiVAD support as BTT. The United Network of Organ Sharing database was retrospectively queried from January 2005 to December 2014 to identify adult patients undergoing heart transplantation (n = 17,022). Patients supported with either TAH (n = 212) or BiVAD (n = 366) at the time of transplantation were evaluated. Pre- and post-transplantation Kaplan-Meier survival curves were examined. Cox regression model was used to study the hazard ratios of the association between TAH versus BiVAD support and post-transplant survival. The median age of the study groups was 49.8 ± 12.9 (TAH) and 47.2 ± 13.9 (BiVAD) years (range 18-74 years). There were more men, 87% versus 74%, in the TAH group (p < 0.0001) with greater body mass index, 27.3 ± 5.2 versus 25.6 ± 4.7 (p < 0.0001), compared to those with BiVADs. Creatinine was higher, 1.7 + 1.2 versus 1.3 + 0.8 mg/dL (p < 0.0001), in the TAH group before transplant. The 30-day, one-, and three-year post-transplantation survival was 88%, 78%, and 67%, respectively, for patients with TAH support versus 93%, 83%, and 73% (p = 0.06) for patients with BiVAD support. Cox regression model shows pre-transplant creatinine (HR = 1.21, p = 0.008) is associated with a lower post-transplant survival. TAH is not associated with a worse post-transplant survival (p = 0.1). There was no difference in wait-list survival in patients supported with TAH or BiVAD (p = 0.8). Although there has been a recent increase in the use of the TAH as BTT, BiVAD support remains a viable option with similar post-transplant survival. © 2016 Wiley Periodicals, Inc.

Measurement of blood flow from an assist ventricle by computation of pneumatic driving parameters.

PubMed

Qian, K X

1992-03-01

The measurement of blood flow from an assist ventricle is important but sometimes difficult in artificial heart experiments. Along with the development of a pneumatic cylinder-piston driver coupled with a ventricular assist device, a simplified method for measuring pump flow was established. From driving parameters such as the piston (or cylinder) displacement and air pressure, the pump flow could be calculated by the use of the equation of state for an ideal gas. The results of this method are broadly in agreement with electromagnetic and Doppler measurements.

Ethics in biomedical engineering.

PubMed

Morsy, Ahmed; Flexman, Jennifer

2008-01-01

This session focuses on a number of aspects of the subject of Ethics in Biomedical Engineering. The session starts by providing a case study of a company that manufactures artificial heart valves where the valves were failing at an unexpected rate. The case study focuses on Biomedical Engineers working at the company and how their education and training did not prepare them to deal properly with such situation. The second part of the session highlights the need to learn about various ethics rules and policies regulating research involving human or animal subjects.

CAD-design, stress analysis and in vitro evaluation of three leaflet blood-pump valves.

PubMed

Knierbein, B; Rosarius, N; Unger, A; Reul, H; Rau, G

1992-07-01

The computer-supported development of valves for cardiac-assist devices or artificial hearts is shown in relation to plastic technology. A CAD-system is used for the design development, whereas the dimensioning of the critical and highly stressed membranes is examined by FEM-analyses. Economic manufacture is permitted by the combined thermoforming-dip moulding technique; the blood-side components are made from biocompatible polyurethane to minimize blood damage. The first long-term results in the test set-up are compared to the FEM results.

Ion engine propelled Earth-Mars cycler with nuclear thermal propelled transfer vehicle, volume 2

NASA Technical Reports Server (NTRS)

Meyer, Rudolf X.; Baker, Myles; Melko, Joseph

1994-01-01

The goal of this project was to perform a preliminary design of a long term, reusable transportation system between earth and Mars which would be capable of providing both artificial gravity and shelter from solar flare radiation. The heart of this system was assumed to be a Cycler spacecraft propelled by an ion propulsion system. The crew transfer vehicle was designed to be propelled by a nuclear-thermal propulsion system. Several Mars transportation system architectures and their associated space vehicles were designed.

Microinjection of muscimol into the dorsomedial hypothalamus suppresses MDMA-evoked sympathetic and behavioral responses

PubMed Central

Rusyniak, Daniel E.; Zaretskaia, Maria V.; Zaretsky, Dmitry V.; DiMicco, Joseph A.

2008-01-01

When given systemically to rats and humans, the drug of abuse 3–4 methylenedioxymethamphetamine (ecstasy, MDMA) elicits hyperthermia, hyperactivity, tachycardia, and hypertension. Chemically stimulating the dorsomedial hypothalamus (DMH), a brain region known to be involved in thermoregulation and in stress responses, causes similar effects. We therefore tested the hypothesis that neuronal activity in the DMH plays a role in MDMA-evoked sympathetic and behavioral responses by microinjecting artificial CSF or muscimol, a neuronal inhibitor, into the DMH prior to intravenous infusion of saline or MDMA in conscious rats. Core temperature, heart rate, mean arterial pressure and locomotor activity were recorded by telemetry every minute for 120 minutes. In rats previously microinjected with CSF, MDMA elicited significant increases from baseline in core temperature (+1.3 ± 0.3°C), locomotion (+50 ± 6 counts/min), heart rate (+142 ± 16 beats/min), and mean arterial pressure (+26 ±3 mmHg). Microinjecting muscimol into the DMH prior to MDMA prevented increases in core temperature and locomotion and attenuated increases in heart rate and mean arterial pressure. These results indicate that neuronal activity in the DMH is necessary for the sympathetic and behavioral responses evoked by MDMA. PMID:18586013

Aid decision algorithms to estimate the risk in congenital heart surgery.

PubMed

Ruiz-Fernández, Daniel; Monsalve Torra, Ana; Soriano-Payá, Antonio; Marín-Alonso, Oscar; Triana Palencia, Eddy

2016-04-01

In this paper, we have tested the suitability of using different artificial intelligence-based algorithms for decision support when classifying the risk of congenital heart surgery. In this sense, classification of those surgical risks provides enormous benefits as the a priori estimation of surgical outcomes depending on either the type of disease or the type of repair, and other elements that influence the final result. This preventive estimation may help to avoid future complications, or even death. We have evaluated four machine learning algorithms to achieve our objective: multilayer perceptron, self-organizing map, radial basis function networks and decision trees. The architectures implemented have the aim of classifying among three types of surgical risk: low complexity, medium complexity and high complexity. Accuracy outcomes achieved range between 80% and 99%, being the multilayer perceptron method the one that offered a higher hit ratio. According to the results, it is feasible to develop a clinical decision support system using the evaluated algorithms. Such system would help cardiology specialists, paediatricians and surgeons to forecast the level of risk related to a congenital heart disease surgery. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Weaving for heart valve tissue engineering.

PubMed

Liberski, Albert; Ayad, Nadia; Wojciechowska, Dorota; Kot, Radoslaw; Vo, Duy M P; Aibibu, Dilibaier; Hoffmann, Gerald; Cherif, Chokri; Grobelny-Mayer, Katharina; Snycerski, Marek; Goldmann, Helmut

2017-11-01

Weaving is a resourceful technology which offers a large selection of solutions that are readily adaptable for tissue engineering (TE) of artificial heart valves (HV). The different ways that the yarns are interlaced in this technique could be used to produce complex architectures, such as the three-layer architecture of the leaflets. Once the assembly is complete, growth of cells in the scaffold would occur in the orientation of the yarn, enabling the deposition of extra cellular matrixes proteins in an oriented manner. Weaving technology is a rapidly evolving field that, first, needs to be understood, and then explored by tissue engineers, so that it could be used to create efficient scaffolds. Similarly, the textile engineers need to gain a basic understanding of key structural and mechanical aspects of the heart valve. The aim of this review is to provide the platform for joining these two fields and to enable cooperative research efforts. Moreover, examples of woven medical products and patents as well as related publication are discussed in this review, nevertheless due to the large, and continuously growing volume of data, only the aspects strictly associated with HVTE lay in the scope of this paper. Copyright © 2017 Elsevier Inc. All rights reserved.

Chronic Heart Failure Follow-up Management Based on Agent Technology

PubMed Central

Safdari, Reza

2015-01-01

Objectives Monitoring heart failure patients through continues assessment of sign and symptoms by information technology tools lead to large reduction in re-hospitalization. Agent technology is one of the strongest artificial intelligence areas; therefore, it can be expected to facilitate, accelerate, and improve health services especially in home care and telemedicine. The aim of this article is to provide an agent-based model for chronic heart failure (CHF) follow-up management. Methods This research was performed in 2013-2014 to determine appropriate scenarios and the data required to monitor and follow-up CHF patients, and then an agent-based model was designed. Results Agents in the proposed model perform the following tasks: medical data access, communication with other agents of the framework and intelligent data analysis, including medical data processing, reasoning, negotiation for decision-making, and learning capabilities. Conclusions The proposed multi-agent system has ability to learn and thus improve itself. Implementation of this model with more and various interval times at a broader level could achieve better results. The proposed multi-agent system is no substitute for cardiologists, but it could assist them in decision-making. PMID:26618038

Translational Applications of Tissue Engineering in Cardiovascular Medicine.

PubMed

Dogan, Arin; Elcin, A Eser; Elcin, Y Murat

2017-03-26

Cardiovascular diseases are the leading cause of global deaths. The current paradigm in medicine seeks novel approaches for the treatment of progressive or end-stage diseases. The organ transplantation option is limited in availability, and unfortunately, a significant number of patients are lost while waiting for donor organs. Animal studies have shown that upon myocardial infarction, it is possible to stop adverse remodeling in its tracks and reverse with tissue engineering methods. Regaining the myocardium function and avoiding further deterioration towards heart failure can benefit millions of people with a significantly lesser burden on healthcare systems worldwide. The advent of induced pluripotent stem cells brings the unique advantage of testing candidate drug molecules on organ-on-chip systems, which mimics human heart in vitro. Biomimetic three-dimensional constructs that contain disease-specific or normal cardiomyocytes derived from human induced pluripotent stem cells are a useful tool for screening drug molecules and studying dosage, mode of action and cardio-toxicity. Tissue engineering approach aims to develop the treatments for heart valve deficiency, ischemic heart disease and a wide range of vascular diseases. Translational research seeks to improve the patient's quality of life, progressing towards developing cures, rather than treatments. To this end, researchers are working on tissue engineered heart valves, blood vessels, cardiac patches, and injectable biomaterials, hence developing new ways for engineering bio-artificial organs or tissue parts that the body will adopt as its own. In this review, we summarize translational methods for cardiovascular tissue engineering and present useful tables on pre-clinical and clinical applications. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Improving pacemaker therapy in congenital heart disease: contractility and resynchronization.

PubMed

Karpawich, Peter P

2015-01-01

Designed as effective therapy for patients with symptomatic bradycardia, implantable cardiac pacemakers initially served to improve symptoms and survival. With initial applications to the elderly and those with severe myocardial disease, extended longevity was not a major concern. However, with design technology advances in leads and generators since the 1980s, pacemaker therapy is now readily applicable to all age patients, including children with congenital heart defects. As a result, emphasis and clinical interests have advanced beyond simply quantity to quality of life. Adverse cardiac effects of pacing from right ventricular apical or epicardial sites with resultant left bundle branch QRS configurations have been recognized. As a result, and with the introduction of newer catheter-delivered pacing leads, more recent studies have focused on alternative or select pacing sites such as septal, outflow tract, and para-bundle of His. This is especially important in dealing with pacemaker therapy among younger patients and those with congenital heart disease, with expected decades of artificial cardiac stimulation, in which adverse myocellular changes secondary to pacing itself have been reported. As a correlate to these alternate or select pacing sites, applications of left ventricular pacing, either via the coronary sinus, intraseptal or epicardial, alone or in combination with right ventricular pacing, have gained interest for patients with heart failure. Although cardiac resynchronization pacing has, to date, had limited clinical applications among patients with congenital heart disease, the few published reports do indicate potential benefits as a bridge to cardiac transplant. Copyright © 2015 Elsevier Inc. All rights reserved.

Impact of pre-transplant pulmonary hypertension on survival after heart transplantation: a UNOS registry analysis.

PubMed

Vakil, Kairav; Duval, Sue; Sharma, Alok; Adabag, Selcuk; Abidi, Kashan Syed; Taimeh, Ziad; Colvin-Adams, Monica

2014-10-20

Severe pre-transplant pulmonary hypertension (PH) has been associated with adverse short-term clinical outcomes after heart transplantation in relatively small single-center studies. The impact of pre-transplant PH on long-term survival after heart transplantation has not been examined in a large, multi-center cohort. Adults (≥18 years) who underwent first time heart transplantation in the United States between 1987 and 2012 were retrospectively identified from the United Network for Organ Sharing registry. Pre-transplant PH was classified as mild, moderate, or severe based on pulmonary vascular resistance (PVR), trans-pulmonary gradient (TPG), and pulmonary artery (PA) mean pressure. Primary outcome was all-cause mortality. Data from 26,649 heart transplant recipients (mean age 52±12 years; 76% male; 76% Caucasian) were analyzed. During a mean follow-up of 5.7±4.8 years, there were 10,334 (39%) deaths. Pre-transplant PH (PVR≥2.5 WU) was a significant predictor of mortality (hazard ratio 1.10, 95% confidence interval 1.05-1.14, p<0.0001) in multivariable analysis. However, the severity of pre-transplant PH (mild/moderate vs. severe) did not affect short or long-term survival. Similarly, even in patients who were supported with either a left ventricular assist device or a total artificial heart prior to transplant, severe pre-transplant PH was not associated with worse survival when compared to patients with mild/moderate pre-transplant PH. Pre-transplant PH (PVR≥2.5 WU) is associated with a modest increase in mortality when compared to patients without pre-transplant PH. However, the severity of pre-transplant PH, assessed by PVR, TPG, or mean PA pressure, is not a discriminating factor for poor survival in patients listed for heart transplantation. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Evolution of membrane oxygenator technology for utilization during pediatric cardiopulmonary bypass.

PubMed

Melchior, Richard W; Sutton, Steven W; Harris, William; Dalton, Heidi J

2016-01-01

The development of the membrane oxygenator for pediatric cardiopulmonary bypass has been an incorporation of ideology and technological advancements with contributions by many investigators throughout the past two centuries. With the pursuit of this technological achievement, the ability to care for mankind in the areas of cardiac surgery has been made possible. Heart disease can affect anyone within the general population, but one such segment that it can affect from inception includes children. Currently, congenital heart defects are the most common birth defects nationally and worldwide. A large meta-analysis study from 1930 to 2010 was conducted in review of published medical literature totaling 114 papers with a study population of 24,091,867 live births, and divulged a staggering incidence of congenital heart disease involving 164,396 subjects with diverse cardiac illnesses. The prevalence of these diseases increased from 0.6 per 1,000 live births from 1930-1934 to 9.1 per 1,000 live births after 1995. These data reveal an emphasis on a growing public health issue regarding congenital heart disease. This discovery displays a need for heightened awareness in the scientific and medical industrial community to accelerate investigative research on emerging cardiovascular devices in an effort to confront congenital anomalies. One such device that has evolved over the past several decades is the pediatric membrane oxygenator. The pediatric membrane oxygenator, in conjunction with the heart lung machine, assists in the repair of most congenital cardiac defects. Numerous children born with congenital heart disease with or without congestive heart failure have experienced improved clinical outcomes in quality of life, survival, and mortality as a result of the inclusion of this technology during their cardiac surgical procedure. The purpose of this review is to report a summary of the published medical and scientific literature related to development of the pediatric membrane oxygenator from its conceptual evolutionary stages to artificially supporting whole body perfusion in the modern pediatric cardiac surgical setting.

Corrosion resistance of premodeled wires made of stainless steel used for heart electrotherapy leaders

NASA Astrophysics Data System (ADS)

Przondziono, J.; Walke, W.; Młynarski, R.; Szatka, W.

2012-05-01

The purpose of the study is to evaluate resistance to electrochemical corrosion of wire made of X10CrNi18-8 stainless steel designed for use in cardiology treatment. The influence of strain formed in the premodeling process and methods of wire surface preparation to corrosive resistance in artificial plasma solution were analysed. Wire corrosion tests were carried out in the solution of artificial plasma. Resistance to electrochemical corrosion was evaluated on the ground of recorded curves of anodic polarization by means of potentiodynamic method. Potentiodynamic tests carried out enabled to determine how the resistance to pitting corrosion of wire changes, depending on strain formed in the premodeling process as well as on the method of wire surface preparation. For evaluation of phenomena occurring on the surface of tested steel, electrochemical impedance spectroscopy (EIS) was applied. Deterioration of corrosive properties of wire along with the increase in the formed strain hardening was observed.

Intelligent freeform manufacturing of complex organs.

PubMed

Wang, Xiaohong

2012-11-01

Different from the existing tissue engineering strategies, rapid prototyping (RP) techniques aim to automatically produce complex organs directly from computer-aided design freeform models with high resolution and sophistication. Analogous to building a nuclear power plant, cell biology (especially, renewable stem cells), implantable biomaterials, tissue engineering, and single/double/four nozzle RP techniques currently enable researchers in the field to realize a part of the task of complex organ manufacturing. To achieve this multifaceted undertaking, a multi-nozzle rapid prototyping system which can simultaneously integrate an anti-suture vascular system, multiple cell types, and a cocktail of growth factors in a construct should be developed. This article reviews the pros and cons of the existing cell-laden RP techniques for complex organ manufacturing. It is hoped that with the comprehensive multidisciplinary efforts, the implants can virtually replace the functions of a solid internal organ, such as the liver, heart, and kidney. © 2012, Copyright the Author. Artificial Organs © 2012, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Linear and nonlinear ARMA model parameter estimation using an artificial neural network

NASA Technical Reports Server (NTRS)

Chon, K. H.; Cohen, R. J.

1997-01-01

This paper addresses parametric system identification of linear and nonlinear dynamic systems by analysis of the input and output signals. Specifically, we investigate the relationship between estimation of the system using a feedforward neural network model and estimation of the system by use of linear and nonlinear autoregressive moving-average (ARMA) models. By utilizing a neural network model incorporating a polynomial activation function, we show the equivalence of the artificial neural network to the linear and nonlinear ARMA models. We compare the parameterization of the estimated system using the neural network and ARMA approaches by utilizing data generated by means of computer simulations. Specifically, we show that the parameters of a simulated ARMA system can be obtained from the neural network analysis of the simulated data or by conventional least squares ARMA analysis. The feasibility of applying neural networks with polynomial activation functions to the analysis of experimental data is explored by application to measurements of heart rate (HR) and instantaneous lung volume (ILV) fluctuations.

Artificial gravity: head movements during short-radius centrifugation

NASA Technical Reports Server (NTRS)

Young, L. R.; Hecht, H.; Lyne, L. E.; Sienko, K. H.; Cheung, C. C.; Kavelaars, J.

2001-01-01

Short-radius centrifugation is a potential countermeasure to long-term weightlessness. Unfortunately, head movements in a rotating environment induce serious discomfort, non-compensatory vestibulo-ocular reflexes, and subjective illusions of body tilt. In two experiments we investigated the effects of pitch and yaw head movements in participants placed supine on a rotating bed with their head at the center of rotation, feet at the rim. The vast majority of participants experienced motion sickness, inappropriate vertical nystagmus and illusory tilt and roll as predicted by a semicircular canal model. However, a small but significant number of the 28 participants experienced tilt in the predicted plane but in the opposite direction. Heart rate was elevated following one-second duration head turns. Significant adaptation occurred following a series of head turns in the light. Vertical nystagmus, motion sickness and illusory tilt all decreased with adaptation. Consequences for artificial gravity produced by short-radius centrifuges as a countermeasure are discussed. Grant numbers: NCC 9-58. c 2001. Elsevier Science Ltd. All rights reserved.

Risk factors for nonreassuring fetal heart rate tracings after artificial rupture of membranes in spontaneous labor.

PubMed

Ganer Herman, Hadas; Tamayev, Liliya; Houli, Rotem; Miremberg, Hadas; Bar, Jacob; Kovo, Michal

2018-04-24

We aimed to characterize factors associated with nonreassuring fetal heart (FHR) tracings after artificial rupture of membranes (AROM), during the active phase of labor. Delivery charts of patients who presented in spontaneous labor, at term, between 2015 and 2016 were reviewed. We identified cases in which AROM was performed during the active stage of labor. We compared deliveries with a normal FHR and those who developed nonreassuring FHR. Nonreassuring FHR was defined as fetal tracing that necessitated intrauterine resuscitation, which included: oxytocin withheld, amnioinfusion, or immediate instrumental or cesarean birth. Of 664 deliveries, nonreassuring FHR occurred in 141 (21.2%) and normal FHR in 523 (78.7%). Both groups were notable for similar maternal characteristics and a similar gestational age. Epidural block was significantly more common in the nonreassuring FHR group (P < .001), as was meconium during delivery (P = .01). Deliveries in the nonreassuring FHR group were characterized by significantly lower Bishop scores at AROM. Mean birthweight was significantly lower in the nonreassuring FHR group (3201 ± 418 vs 3342 ± 376 g, P < .001), yet, neonatal outcome did not differ between the groups. In a multivariate logistic regression model, nulliparity, AROM at a station lower than -2, and increased birthweight were all significantly associated with a decreased rate of nonreassuring FHR, while prolonged duration from AROM to delivery and oxytocin augmentation significantly increased the risk for nonreassuring FHR. Nonreassuring FHR after AROM during delivery is associated with parity, fetal station at AROM, birthweight, and oxytocin augmentation. © 2018 Wiley Periodicals, Inc.

Description of a flow optimized oxygenator with integrated pulsatile pump.

PubMed

Borchardt, Ralf; Schlanstein, Peter; Arens, Jutta; Graefe, Roland; Schreiber, Fabian; Schmitz-Rode, Thomas; Steinseifer, Ulrich

2010-11-01

Extracorporeal membrane oxygenation (ECMO) is a well-established therapy for several lung and heart diseases in the field of neonatal and pediatric medicine (e.g., acute respiratory distress syndrome, congenital heart failure, cardiomyopathy). Current ECMO systems are typically composed of an oxygenator and a separate nonpulsatile blood pump. An oxygenator with an integrated pulsatile blood pump for small infant ECMO was developed, and this novel concept was tested regarding functionality and gas exchange rate. Pulsating silicone tubes (STs) were driven by air pressure and placed inside the cylindrical fiber bundle of an oxygenator to be used as a pump module. The findings of this study confirm that pumping blood with STs is a viable option for the future. The maximum gas exchange rate for oxygen is 48mL/min/L(blood) at a medium blood flow rate of about 300mL/min. Future design steps were identified to optimize the flow field through the fiber bundle to achieve a higher gas exchange rate. First, the packing density of the hollow-fiber bundle was lower than commercial oxygenators due to the manual manufacturing. By increasing this packing density, the gas exchange rate would increase accordingly. Second, distribution plates for a more uniform blood flow can be placed at the inlet and outlet of the oxygenator. Third, the hollow-fiber membranes can be individually placed to ensure equal distances between the surrounding hollow fibers. © 2010, Copyright the Authors. Artificial Organs © 2010, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Development of data communication system with ultra high frequency radio wave for implantable artificial hearts.

PubMed

Tsujimura, Shinichi; Yamagishi, Hiroto; Sankai, Yoshiyuki

2009-01-01

In order to minimize infection risks of patients with artificial hearts, wireless data transmission methods with electromagnetic induction or light have been developed. However, these methods tend to become difficult to transmit data if the external data transmission unit moves from its proper position. To resolve this serious problem, the purpose of this study is to develop a prototype wireless data communication system with ultra high frequency radio wave and confirm its performance. Due to its high-speed communication rate, low power consumption, high tolerance to electromagnetic disturbances, and secure wireless communication, we adopted Bluetooth radio wave technology for our system. The system consists of an internal data transmission unit and an external data transmission unit (53 by 64 by 16 mm, each), and each has a Bluetooth module (radio field intensity: 4 dBm, receiver sensitivity: -80 dBm). The internal unit also has a micro controller with an 8-channel 10-bit A/D converter, and the external unit also has a RS-232C converter. We experimented with the internal unit implanted into pig meat, and carried out data transmission tests to evaluate the performance of this system in tissue thickness of up to 3 mm. As a result, data transfer speeds of about 20 kbps were achieved within the communication distance of 10 m. In conclusion, we confirmed that the system can wirelessly transmit the data from the inside of the body to the outside, and it promises to resolve unstable data transmission due to accidental movements of an external data transmission unit.

Elective decompression of the left ventricle in pediatric patients may reduce the duration of venoarterial extracorporeal membrane oxygenation.

PubMed

Hacking, Douglas F; Best, Derek; d'Udekem, Yves; Brizard, Christian P; Konstantinov, Igor E; Millar, Johnny; Butt, Warwick

2015-04-01

We aimed to determine the effect of elective left heart decompression at the time of initiation of central venoarterial extracorporeal membrane oxygenation (VA ECMO) on VA ECMO duration and clinical outcomes in children in a single tertiary ECMO referral center with a large pediatric population from a national referral center for pediatric cardiac surgery. We studied 51 episodes of VA ECMO in a historical cohort of 49 pediatric patients treated between the years 1990 and 2013 in the Paediatric Intensive Care Unit (PICU) of the Royal Children's Hospital, Melbourne. The cases had a variety of diagnoses including congenital cardiac abnormalities, sepsis, myocarditis, and cardiomyopathy. Left heart decompression as an elective treatment or an emergency intervention for left heart distension was effectively achieved by a number of methods, including left atrial venting, blade atrial septostomy, and left ventricular cannulation. Elective left heart decompression was associated with a reduction in time on ECMO (128 h) when compared with emergency decompression (236 h) (P = 0.013). Subgroup analysis showed that ECMO duration was greatest in noncardiac patients (elective 138 h, emergency 295 h; P = 0.02) and in patients who died despite both emergency decompression and ECMO (elective 133 h, emergency 354 h; P = 0.002). As the emergency cases had a lower pH, a higher PaCO2 , and a lower oxygenation index and were treated with a higher mean airway pressure, positive end-expiratory pressure, and respiratory rate prior to receiving VA ECMO, we undertook multivariate linear regression modeling to show that only PaCO2 and the timing of left heart decompression were associated with ECMO duration. However, elective left heart decompression was not associated with a reduction in length of PICU stay, duration of mechanical ventilation, or duration of oxygen therapy. Elective left heart decompression was not associated with improved ECMO survival or survival to PICU discharge. Elective left heart decompression may reduce ECMO duration and has therefore the potential to reduce ECMO-related complications. A prospective, randomized controlled trial is indicated to study this intervention further. Copyright © 2014 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

A comparative analysis of predictive models of morbidity in intensive care unit after cardiac surgery - part II: an illustrative example.

PubMed

Cevenini, Gabriele; Barbini, Emanuela; Scolletta, Sabino; Biagioli, Bonizella; Giomarelli, Pierpaolo; Barbini, Paolo

2007-11-22

Popular predictive models for estimating morbidity probability after heart surgery are compared critically in a unitary framework. The study is divided into two parts. In the first part modelling techniques and intrinsic strengths and weaknesses of different approaches were discussed from a theoretical point of view. In this second part the performances of the same models are evaluated in an illustrative example. Eight models were developed: Bayes linear and quadratic models, k-nearest neighbour model, logistic regression model, Higgins and direct scoring systems and two feed-forward artificial neural networks with one and two layers. Cardiovascular, respiratory, neurological, renal, infectious and hemorrhagic complications were defined as morbidity. Training and testing sets each of 545 cases were used. The optimal set of predictors was chosen among a collection of 78 preoperative, intraoperative and postoperative variables by a stepwise procedure. Discrimination and calibration were evaluated by the area under the receiver operating characteristic curve and Hosmer-Lemeshow goodness-of-fit test, respectively. Scoring systems and the logistic regression model required the largest set of predictors, while Bayesian and k-nearest neighbour models were much more parsimonious. In testing data, all models showed acceptable discrimination capacities, however the Bayes quadratic model, using only three predictors, provided the best performance. All models showed satisfactory generalization ability: again the Bayes quadratic model exhibited the best generalization, while artificial neural networks and scoring systems gave the worst results. Finally, poor calibration was obtained when using scoring systems, k-nearest neighbour model and artificial neural networks, while Bayes (after recalibration) and logistic regression models gave adequate results. Although all the predictive models showed acceptable discrimination performance in the example considered, the Bayes and logistic regression models seemed better than the others, because they also had good generalization and calibration. The Bayes quadratic model seemed to be a convincing alternative to the much more usual Bayes linear and logistic regression models. It showed its capacity to identify a minimum core of predictors generally recognized as essential to pragmatically evaluate the risk of developing morbidity after heart surgery.

Electroactive 3D materials for cardiac tissue engineering

NASA Astrophysics Data System (ADS)

Gelmi, Amy; Zhang, Jiabin; Cieslar-Pobuda, Artur; Ljunngren, Monika K.; Los, Marek Jan; Rafat, Mehrdad; Jager, Edwin W. H.

2015-04-01

By-pass surgery and heart transplantation are traditionally used to restore the heart's functionality after a myocardial Infarction (MI or heart attack) that results in scar tissue formation and impaired cardiac function. However, both procedures are associated with serious post-surgical complications. Therefore, new strategies to help re-establish heart functionality are necessary. Tissue engineering and stem cell therapy are the promising approaches that are being explored for the treatment of MI. The stem cell niche is extremely important for the proliferation and differentiation of stem cells and tissue regeneration. For the introduction of stem cells into the host tissue an artificial carrier such as a scaffold is preferred as direct injection of stem cells has resulted in fast stem cell death. Such scaffold will provide the proper microenvironment that can be altered electronically to provide temporal stimulation to the cells. We have developed an electroactive polymer (EAP) scaffold for cardiac tissue engineering. The EAP scaffold mimics the extracellular matrix and provides a 3D microenvironment that can be easily tuned during fabrication, such as controllable fibre dimensions, alignment, and coating. In addition, the scaffold can provide electrical and electromechanical stimulation to the stem cells which are important external stimuli to stem cell differentiation. We tested the initial biocompatibility of these scaffolds using cardiac progenitor cells (CPCs), and continued onto more sensitive induced pluripotent stem cells (iPS). We present the fabrication and characterisation of these electroactive fibres as well as the response of increasingly sensitive cell types to the scaffolds.

Heart rate responses provide an objective evaluation of human disturbance stimuli in breeding birds.

PubMed

Ellenberg, Ursula; Mattern, Thomas; Seddon, Philip J

2013-01-01

Intuition is a poor guide for evaluating the effects of human disturbance on wildlife. Using the endangered Yellow-eyed penguin, Megadyptes antipodes, as an example, we show that heart rate responses provide an objective tool to evaluate human disturbance stimuli and encourage the wider use of this simple and low-impact approach. Yellow-eyed penguins are a flagship species for New Zealand's wildlife tourism; however, unregulated visitor access has recently been associated with reduced breeding success and lower first year survival. We measured heart rate responses of Yellow-eyed penguins via artificial eggs to evaluate a range of human stimuli regularly occurring at their breeding sites. We found the duration of a stimulus to be the most important factor, with elevated heart rate being sustained while a person remained within sight. Human activity was the next important component; a simulated wildlife photographer, crawling slowly around during his stay, elicited a significantly higher heart rate response than an entirely motionless human spending the same time at the same distance. Stimuli we subjectively might perceive as low impact, such as the careful approach of a 'wildlife photographer', resulted in a stronger response than a routine nest-check that involved lifting a bird up to view nest contents. A single, slow-moving human spending 20 min within 2 m from the nest may provoke a response comparable to that of 10 min handling a bird for logger deployment. To reduce cumulative impact of disturbance, any human presence in the proximity of Yellow-eyed penguins needs to be kept at a minimum. Our results highlight the need for objective quantification of the effects of human disturbance in order to provide a sound basis for guidelines to manage human activity around breeding birds.

The analgesic efficacy of oxycodone hydrochloride versus fentanyl during outpatient artificial abortion operation: A randomized trial.

PubMed

Xie, Kangjie; Zhang, Wen; Fang, Wumei; Lian, Yanhong; Lin, Sufeng; Fang, Jun

2017-06-01

Problems like body movement, respiratory depression, and complained of pain are still common phenomenon in outpatient artificial abortion general anesthesia. Oxycodone hydrochloride is a semisynthetic opioid and has a good therapeutic effect on visceral pain. We hypothesize that oxycodone hydrochloride would be superior to fentanyl in outpatient artificial abortion surgery. In this clinical trial 149 American Society of Anesthesiologists (ASA) I or II female outpatients scheduled for elective artificial abortion surgeries under general anesthesia were randomly divided into 3 groups: oxycodone hydrochloride 0.06 mg/kg group (group A), oxycodone hydrochloride 0.08 mg/kg group (group B), and control group fentanyl 2 ug/kg (group C). The primary outcome was level body movement and respiratory depression during the surgery, the second outcome included the visual analogue scale (VAS) score 30 minutes after waking. A total of 120 participants completed the study, n = 40 in each group. There was no significant difference in patients' age, body mass index (BMI), preoperative heart rate, mean arterial blood pressure, consumption dose of propofol, intraoperative body movement type and times, and duration of surgery among the 3 groups (P > .05). Comparing the incidence of intraoperative respiratory depression and SPO2 < 90% among the 3 groups, group C's was significantly higher than those of groups A and B, and the difference was statistically significant (P < .05). Group A had no difference compared with group B. In VAS score 30minutes after waking, group C was the highest, followed by group A, with group B as the lowest. The difference among the 3 groups was statistically significant (P < .05), but a difference delta less than 1 on the VAS scale is not clinically significant. The analgesic effect of oxycodone hydrochloride at 0.06 mg/kg applied to painless artificial abortion surgery is not superior than that of fentanyl, but the incidence of intraoperative respiratory depression and hypoxemia is significantly lower than fentanyl.

Off-pump transapical implantation of artificial neo-chordae to correct mitral regurgitation: the TACT Trial (Transapical Artificial Chordae Tendinae) proof of concept.

PubMed

Seeburger, Joerg; Rinaldi, Mauro; Nielsen, Sten Lyager; Salizzoni, Stefano; Lange, Ruediger; Schoenburg, Markus; Alfieri, Ottavio; Borger, Michael Andrew; Mohr, Friedrich Wilhelm; Aidietis, Audrius

2014-03-11

The goal of this study was to evaluate the safety and performance of the NeoChord DS1000 system (NeoChord, Inc., Minneapolis, Minnesota). There is an increasing interest in transcatheter mitral valve (MV) treatment. The NeoChord DS 1000 system enables off-pump beating heart transapical MV repair with implantation of artificial neo-chordae. Patients with severe mitral regurgitation (MR) due to isolated posterior prolapse were included in this TACT (Transapical Artificial Chordae Tendinae) trial. All patients were scheduled for off-pump transapical implantation of neo-chordae. Thirty patients at 7 centers were enrolled. Major adverse events included 1 death due to post-cardiotomy syndrome and concomitant sepsis and 1 minor stroke with the patient fully recovered at the 30-day follow-up visit. Additional patients experienced procedural major adverse events related to a reoperation or conversion to standard of care. Acute procedural success (placement of at least 1 neo-chord and reduction of MR from 3+ or 4+ to ≤2+) was achieved in 26 patients (86.7%). In 4 patients neo-chordae were not placed for technical and/or patient-specific reasons. These patients underwent intraoperative (3 patients) or post-operative (1 patient) standard MV repair. At 30 days, 17 patients maintained an MR grade ≤2+. Four patients who developed recurrent MR were successfully treated with open MV repair during 30-day follow-up. Results improved with experience: durable reduction in MR to ≤2+ at 30 days was achieved in 5 (33.3%) of the first 15 patients and 12 (85.7%) of the last 14 patients. Off-pump transapical implantation of artificial chordae to correct MR is technically safe and feasible; however, it yields further potential for improvement of efficacy and durability. (Safety and Performance Study of the NeoChord Device [TACT]; NCT01777815). Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Estimating the Information Extracted by a Single Spiking Neuron from a Continuous Input Time Series.

PubMed

Zeldenrust, Fleur; de Knecht, Sicco; Wadman, Wytse J; Denève, Sophie; Gutkin, Boris

2017-01-01

Understanding the relation between (sensory) stimuli and the activity of neurons (i.e., "the neural code") lies at heart of understanding the computational properties of the brain. However, quantifying the information between a stimulus and a spike train has proven to be challenging. We propose a new ( in vitro ) method to measure how much information a single neuron transfers from the input it receives to its output spike train. The input is generated by an artificial neural network that responds to a randomly appearing and disappearing "sensory stimulus": the hidden state. The sum of this network activity is injected as current input into the neuron under investigation. The mutual information between the hidden state on the one hand and spike trains of the artificial network or the recorded spike train on the other hand can easily be estimated due to the binary shape of the hidden state. The characteristics of the input current, such as the time constant as a result of the (dis)appearance rate of the hidden state or the amplitude of the input current (the firing frequency of the neurons in the artificial network), can independently be varied. As an example, we apply this method to pyramidal neurons in the CA1 of mouse hippocampi and compare the recorded spike trains to the optimal response of the "Bayesian neuron" (BN). We conclude that like in the BN, information transfer in hippocampal pyramidal cells is non-linear and amplifying: the information loss between the artificial input and the output spike train is high if the input to the neuron (the firing of the artificial network) is not very informative about the hidden state. If the input to the neuron does contain a lot of information about the hidden state, the information loss is low. Moreover, neurons increase their firing rates in case the (dis)appearance rate is high, so that the (relative) amount of transferred information stays constant.

COMPARISON OF ARTIFICIAL NEOCHORDAE AND NATIVE CHORDAL TRANSFER IN THE REPAIR OF A FLAIL POSTERIOR MITRAL LEAFLET: AN EXPERIMENTAL STUDY

PubMed Central

Padala, Muralidhar; Cardinau, Benedicte; Gyoneva, Lazarina I.; Thourani, Vinod H.

2013-01-01

BACKGROUND Surgical reconstruction of a flail posterior leaflet is a routine mitral valve repair, the techniques for which have evolved from leaflet resection to leaflet preservation. Artificial ePTFE neochordae are frequently used to stabilize the flail leaflet, and seldom translocation of the native secondary chordae of the valve to the leaflet free edge is used. In this study, we sought to investigate the efficacy of the two techniques to correct posterior leaflet prolapse and reduce mitral regurgitation, and quantify the acute post-repair leaflet kinematics. METHODS Adult porcine mitral valves (N =7) were studied in a pulsatile left heart experimental model in which isolated P2 flail was mimicked by marginal chordal transection. Baseline conditions were established in each valve under normal conditions (control), and followed by induction of isolated P2 flail by transecting the two marginal chordae on the posterior leaflet free edge (disease). The flail posterior leaflet was reconstructed using artificial neochordae (repair 1) and then native chordal translocation (repair 2). Reduction in leaflet flail, changes in mitral regurgitation fraction, leaflet coaptation length, and posterior leaflet mobility were measured using B-mode echocardiography or color doppler. RESULTS At baseline, all the valves were competent with no mitral regurgitation. After transection of the marginal chordae on the posterior leaflet, isolated P2 flail was evident with 13.7±13% regurgitation. Reconstruction with artificial neochordae eliminated leaflet flail and reduced mitral regurgitation to 3.2± 2.8%, and with chordal translocation leaflet flail was corrected and mitral regurgitation was measured at 2.3±2.6%. Using either repair techniques, leaflet coaptation and mobility of the repaired leaflets were adequate and comparable to the baseline measurements. CONCLUSIONS Comparable reduction leaflet flail and regurgitation, and restoration of physiological leaflet coaptation with the two techniques indicates that under acute conditions, use of artificial neochordae or native chordal translocations have similar benefits. PMID:23291143

Potential biomedical applications of ion beam technology

NASA Technical Reports Server (NTRS)

Banks, B. A.; Weigand, A. J.; Babbush, C. A.; Vankampen, C. L.

1976-01-01

Electron bombardment ion thrusters used as ion sources have demonstrated a unique capability to vary the surface morphology of surgical implant materials. The microscopically rough surface texture produced by ion beam sputtering of these materials may result in improvements in the biological response and/or performance of implanted devices. Control of surface roughness may result in improved attachment of the implant to soft tissue, hard tissue, bone cement, or components deposited from blood. Potential biomedical applications of ion beam texturing discussed include: vascular prostheses, artificial heart pump diaphragms, pacemaker fixation, percutaneous connectors, orthopedic pros-thesis fixtion, and dental implants.

Potential biomedical applications of ion beam technology

NASA Technical Reports Server (NTRS)

Banks, B. A.; Weigand, A. J.; Van Kampen, C. L.; Babbush, C. A.

1976-01-01

Electron bombardment ion thrusters used as ion sources have demonstrated a unique capability to vary the surface morphology of surgical implant materials. The microscopically rough surface texture produced by ion beam sputtering of these materials may result in improvements in the biological response and/or performance of implanted devices. Control of surface roughness may result in improved attachment of the implant to soft tissue, hard tissue, bone cement, or components deposited from blood. Potential biomedical applications of ion beam texturing discussed include: vascular prostheses, artificial heart pump diaphragms, pacemaker fixation, percutaneous connectors, orthopedic prosthesis fixation, and dental implants.

Performance assessment techniques for Doppler radar physiological sensors.

PubMed

Hafner, Noah; Lubecke, Victor

2009-01-01

This paper presents a technique for assessing the performance of continuous wave Doppler radar systems for physiological sensing. The technique includes an artificial target for testing physiological sensing radar systems with motion analogous to human heart movement and software algorithms leveraging the capabilities of this target to simply test radar system performance. The mechanical target provides simple to complex patterns of motion that are stable and repeatable. Details of radar system performance can be assessed and the effects of configuration changes that might not appear with a human target can be observed when using this mechanical target.

Construction of PR39 recombinant AAV under control of the HRE promoter and the effect of recombinant AAV on gene therapy of ischemic heart disease

PubMed Central

SUN, LIJUN; HAO, YUEWEN; NIE, XIAOWEI; ZHANG, XUEXIN; YANG, GUANGXIAO; WANG, QUANYING

2012-01-01

The objective of this study was to investigate the effect of the PR39 recombinant adeno-associated virus (AAV) controlled by the hypoxia-responsive element (HRE) on gene therapy of ischemic heart disease. The minimal HRE was artificially synthesized and the AAV vector controlled by HRE was introduced with NT4-TAT-His-PR39 to investigate the expression of AAV-PR39 in hypoxic vascular endothelial cells (VEC) of human umbilical vein (CRL-1730 cell line) and the angiogenesis-promoting effect in pigs with acute myocardial infraction (AMI). The minimal HRE/CMV was designed and artificially synthesized using the PCR method and cloned with the T vector cloning method. The pSS-HRE-CMV-NT4-6His-PR39-PolyA-AAV plasmid was constructed. Using the calcium phosphate precipitation method, HEK-293 cells were co-transfected with three plasmids to produce the recombinant virus. An equal volume of pSS-HRE-CMV-NT4-6His-PR39-PolyAAAV and enterovirus (EV, blank virus) was transfected into CRL-1730 cell lines, respectively. The immunohistochemical method was used to assay the expression of 6xHis in CRL-1730 cell lines and the expression of PR39 under hypoxia. Eighteen AMI miniature pigs were randomized into the experimental group (HRE-AAV-PR39 group), control group 1 (physical saline group) and control group 2 (EV group). The area of ischemia was assessed with conventional MRI and myocardium perfusion MRI. Pigs were sacrificed at preset time-points to obtain samples of ischemic myocardium. Morphological and pathological data were collected. According to data in the literature and databases, the minimal HRE was designed and synthesized with the PCR method. A large number of HREs were connected to modified pSSHGAAV (pSSV9int-/XbaI) vector followed by insertion of the NT4-6His-PR39 gene segment and, thus, the recombinant plasmid pSS-HRE-CMV-NT4-6His-PR39-PolyA-AAV was successfully constructed. The expression of 6xHis in CRL-1730 cells under the regulation of HRE was assayed using the immunohistochemical method and results showed that the expression was positive in the experimental group. Myocardium perfusion MRI displayed that the infracted area significantly decreased under the action of pSS-HRE-CMV-NT4-PR39-PolyA-AAV. The artificial minimal HRE in CRL-1730 cells effectively and rapidly regulates the expression of the downstream gene NT4-TAT-His-PR39 of the CMV promoter. Recombinant pSS-HRE-CMV-NT4-PR39-Poly-AAAV promotes neoangiogenesis in the ischemic area, reduces the area of infarction and improves heart function. PMID:23226731

Construction of PR39 recombinant AAV under control of the HRE promoter and the effect of recombinant AAV on gene therapy of ischemic heart disease.

PubMed

Sun, Lijun; Hao, Yuewen; Nie, Xiaowei; Zhang, Xuexin; Yang, Guangxiao; Wang, Quanying

2012-11-01

The objective of this study was to investigate the effect of the PR39 recombinant adeno-associated virus (AAV) controlled by the hypoxia-responsive element (HRE) on gene therapy of ischemic heart disease. The minimal HRE was artificially synthesized and the AAV vector controlled by HRE was introduced with NT4-TAT-His-PR39 to investigate the expression of AAV-PR39 in hypoxic vascular endothelial cells (VEC) of human umbilical vein (CRL-1730 cell line) and the angiogenesis-promoting effect in pigs with acute myocardial infraction (AMI). The minimal HRE/CMV was designed and artificially synthesized using the PCR method and cloned with the T vector cloning method. The pSS-HRE-CMV-NT4-6His-PR39-PolyA-AAV plasmid was constructed. Using the calcium phosphate precipitation method, HEK-293 cells were co-transfected with three plasmids to produce the recombinant virus. An equal volume of pSS-HRE-CMV-NT4-6His-PR39-PolyAAAV and enterovirus (EV, blank virus) was transfected into CRL-1730 cell lines, respectively. The immunohistochemical method was used to assay the expression of 6xHis in CRL-1730 cell lines and the expression of PR39 under hypoxia. Eighteen AMI miniature pigs were randomized into the experimental group (HRE-AAV-PR39 group), control group 1 (physical saline group) and control group 2 (EV group). The area of ischemia was assessed with conventional MRI and myocardium perfusion MRI. Pigs were sacrificed at preset time-points to obtain samples of ischemic myocardium. Morphological and pathological data were collected. According to data in the literature and databases, the minimal HRE was designed and synthesized with the PCR method. A large number of HREs were connected to modified pSSHGAAV (pSSV9int-/XbaI) vector followed by insertion of the NT4-6His-PR39 gene segment and, thus, the recombinant plasmid pSS-HRE-CMV-NT4-6His-PR39-PolyA-AAV was successfully constructed. The expression of 6xHis in CRL-1730 cells under the regulation of HRE was assayed using the immunohistochemical method and results showed that the expression was positive in the experimental group. Myocardium perfusion MRI displayed that the infracted area significantly decreased under the action of pSS-HRE-CMV-NT4-PR39-PolyA-AAV. The artificial minimal HRE in CRL-1730 cells effectively and rapidly regulates the expression of the downstream gene NT4-TAT-His-PR39 of the CMV promoter. Recombinant pSS-HRE-CMV-NT4-PR39-Poly-AAAV promotes neoangiogenesis in the ischemic area, reduces the area of infarction and improves heart function.

On the space and time evolution of regular or irregular human heart or brain signals

NASA Astrophysics Data System (ADS)

Tuncay, Ç.

2009-01-01

A coupled map is suggested to investigate various spatial or temporal designs in biology: several cells (or tissues) in an organ are considered as connected to each other in terms of some molecular diffusions or electrical potential differences and so on. The biological systems (groups of cells) start from various initial conditions for spatial designs (or initial signals for temporal designs) and they evolve in time in terms of the mentioned interactions (connections) besides some individual feedings. The basic aim of the present contribution is to mimic various empirical data for the heart (in normal, quasi-stable, unstable and post operative physiological conditions) or brain (regular or irregular; for epilepsy) signals. The mentioned empirical data are borrowed from various works in the literature which are cited. The suggested model (to be used besides or instead of the artificial network models) involves simple mathematics and the related software is easy. The results may be considered as in good agreement with the mentioned real signals.

Immersogeometric cardiovascular fluid–structure interaction analysis with divergence-conforming B-splines

PubMed Central

Kamensky, David; Hsu, Ming-Chen; Yu, Yue; Evans, John A.; Sacks, Michael S.; Hughes, Thomas J. R.

2016-01-01

This paper uses a divergence-conforming B-spline fluid discretization to address the long-standing issue of poor mass conservation in immersed methods for computational fluid–structure interaction (FSI) that represent the influence of the structure as a forcing term in the fluid subproblem. We focus, in particular, on the immersogeometric method developed in our earlier work, analyze its convergence for linear model problems, then apply it to FSI analysis of heart valves, using divergence-conforming B-splines to discretize the fluid subproblem. Poor mass conservation can manifest as effective leakage of fluid through thin solid barriers. This leakage disrupts the qualitative behavior of FSI systems such as heart valves, which exist specifically to block flow. Divergence-conforming discretizations can enforce mass conservation exactly, avoiding this problem. To demonstrate the practical utility of immersogeometric FSI analysis with divergence-conforming B-splines, we use the methods described in this paper to construct and evaluate a computational model of an in vitro experiment that pumps water through an artificial valve. PMID:28239201

The Framingham study and treatment guidelines for stroke prevention.

PubMed

Grossi, Enzo

2008-06-01

In recent years, institutional bodies and scientific societies of principal Western countries have produced several guidelines dealing with risk assessment, primary prevention, and treatment of acute stroke. From a prospective, community-based, observational cohort of patients from the Framingham Heart Study, an absolute estimate of risk for stroke alone or stroke or death was determined based on several risk factors, including advanced age, female sex, increased systolic blood pressure, prior stroke or transient ischemic attack, and diabetes mellitus. This algorithm considers many variables and expresses their results as the percentage of risk of developing a fatal or nonfatal stroke in the following 5 years. The author has identified three major pitfalls of this algorithm, which are related to the limitation of the classic statistical approach in handling this kind of nonlinear and complex information: 1) the very large confidence interval of individual risk assessment, 2) the inability to capture the process dynamics, and 3) the inability to capture the disease complexity. The artificial intelligence armamentarium may provide an advantage in the attempt to overcome these limitations. The theoretic background and some application examples related to artificial neural networks (ANNs) and fuzzy logic are reviewed and discussed. Newer approaches linked to artificial intelligence, such as fuzzy logic and ANNs, seem better at addressing the challenge of the increasing complexity of the predisposing factors linked to cerebrovascular events and at predicting future events in an individual patient.

Application of convolutional artificial neural networks to echocardiograms for differentiating congenital heart diseases in a pediatric population

NASA Astrophysics Data System (ADS)

Perrin, Douglas P.; Bueno, Alejandra; Rodriguez, Andrea; Marx, Gerald R.; del Nido, Pedro J.

2017-03-01

In this paper we describe a pilot study, where machine learning methods are used to differentiate between congenital heart diseases. Our approach was to apply convolutional neural networks (CNNs) to echocardiographic images from five different pediatric populations: normal, coarctation of the aorta (CoA), hypoplastic left heart syndrome (HLHS), transposition of the great arteries (TGA), and single ventricle (SV). We used a single network topology that was trained in a pairwise fashion in order to evaluate the potential to differentiate between patient populations. In total we used 59,151 echo frames drawn from 1,666 clinical sequences. Approximately 80% of the data was used for training, and the remainder for validation. Data was split at sequence boundaries to avoid having related images in the training and validation sets. While training was done with echo images/frames, evaluation was performed for both single frame discrimination as well as sequence discrimination (by majority voting). In total 10 networks were generated and evaluated. Unlike other domains where this network topology has been used, in ultrasound there is low visual variation between classes. This work shows the potential for CNNs to be applied to this low-variation domain of medical imaging for disease discrimination.

Physiological demands of downhill mountain biking.

PubMed

Burr, Jamie F; Drury, C Taylor; Ivey, Adam C; Warburton, Darren E R

2012-12-01

Mountain biking is a popular recreational pursuit and the physiological demands of cross-country style riding have been well documented. However, little is known regarding the growing discipline of gravity-assisted downhill cycling. We characterised the physiological demands of downhill mountain biking under typical riding conditions. Riding oxygen consumption (VO(2)) and heart rate (HR) were measured on 11 male and eight female experienced downhill cyclists and compared with data during a standardised incremental to maximum (VO(2max)) exercise test. The mean VO(2) while riding was 23.1 ± 6.9 ml · kg(-1) · min(-1) or 52 ± 14% of VO(2max) with corresponding heart rates of 146 ± 11 bpm (80 ± 6% HRmax). Over 65% of the ride was in a zone at or above an intensity level associated with improvements in health-related fitness. However, the participants' heart rates and ratings of perceived exertion were artificially inflated in comparison with the actual metabolic demands of the downhill ride. Substantial muscular fatigue was evident in grip strength, which decreased 5.4 ± 9.4 kg (5.5 ± 11.2%, P = 0.03) post-ride. Participation in downhill mountain biking is associated with significant physiological demands, which are in a range associated with beneficial effects on health-related fitness.

Heartmate 3 fully magnetically levitated left ventricular assist device for the treatment of advanced heart failure -1 year results from the Ce mark trial.

PubMed

Krabatsch, Thomas; Netuka, Ivan; Schmitto, Jan D; Zimpfer, Daniel; Garbade, Jens; Rao, Vivek; Morshuis, Michiel; Beyersdorf, Friedhelm; Marasco, Silvana; Damme, Laura; Pya, Yuriy

2017-04-04

The HeartMate 3 Left Ventricular Assist System (LVAS) (St. Jude Medical Inc., St Paul, MN) with full magnetic levitation allows for wide and consistent blood flow paths and an artificial pulse designed for enhanced hemocompatibility. The HeartMate 3 received market approval in the European Union in 2015 following completion of a multicenter study. After reaching the 6-month study endpoint, patients continue to be followed for 2 years with the 1-year results presented herein. A prospective, non-randomized study included adults with advanced heart failure and ejection fraction (EF) ≤ 25%, cardiac index (CI) ≤ 2.2 L/min/m2 while not on inotropes, or inotrope dependent, or on optimal medical management for 45/60 days. Fifty patients-54% bridge to transplant (BTT) and 46% destination therapy (DT)-were enrolled and implanted with the HeartMate 3. At baseline, 92% of the patients were INTERMACS profiles 2-4, with cardiac index 1.8 + 0.5 L/min/m 2 and 58% were supported with inotropes. At 1 year, 74% of the patients remain on support, 18% expired, 6% transplanted, and 2% explanted. The adverse events include 12% gastrointestinal bleeding, 16% driveline infections, 18% strokes, and 2% outflow graft thrombosis. There was no hemolysis, pump thrombosis or pump malfunction through 1 year. The six-minute walk test distance increased from a mean of 273 m to 371 m (P <0.0001). EQ-5D quality-of-life score increased from a mean of 52.7 to 70.8 (P = 0.0006). The 1-year HeartMate 3 LVAS results show survival and adverse-event profile are similar to other approved devices, with no pump thrombosis or pump failure. Patient's functional status and quality of life significantly improved over time. Clinicaltrials.gov registration number: NCT02170363 . Registered June 19, 2014.

In Vitro Evaluation of a Novel Hemodynamically Optimized Trileaflet Polymeric Prosthetic Heart Valve

PubMed Central

Claiborne, Thomas E.; Sheriff, Jawaad; Kuetting, Maximilian; Steinseifer, Ulrich; Slepian, Marvin J.; Bluestein, Danny

2013-01-01

Calcific aortic valve disease is the most common and life threatening form of valvular heart disease, characterized by stenosis and regurgitation, which is currently treated at the symptomatic end-stages via open-heart surgical replacement of the diseased valve with, typically, either a xenograft tissue valve or a pyrolytic carbon mechanical heart valve. These options offer the clinician a choice between structural valve deterioration and chronic anticoagulant therapy, respectively, effectively replacing one disease with another. Polymeric prosthetic heart valves (PHV) offer the promise of reducing or eliminating these complications, and they may be better suited for the new transcatheter aortic valve replacement (TAVR) procedure, which currently utilizes tissue valves. New evidence indicates that the latter may incur damage during implantation. Polymer PHVs may also be incorporated into pulsatile circulatory support devices such as total artificial heart and ventricular assist devices that currently employ mechanical PHVs. Development of polymer PHVs, however, has been slow due to the lack of sufficiently durable and biocompatible polymers. We have designed a new trileaflet polymer PHV for surgical implantation employing a novel polymer—xSIBS—that offers superior bio-stability and durability. The design of this polymer PHV was optimized for reduced stresses, improved hemodynamic performance, and reduced thrombogenicity using our device thrombogenicity emulation (DTE) methodology, the results of which have been published separately. Here we present our new design, prototype fabrication methods, hydrodynamics performance testing, and platelet activation measurements performed in the optimized valve prototype and compare it to the performance of a gold standard tissue valve. The hydrodynamic performance of the two valves was comparable in all measures, with a certain advantage to our valve during regurgitation. There was no significant difference between the platelet activation rates of our polymer valve and the tissue valve, indicating that similar to the latter, its recipients may not require anticoagulation. This work proves the feasibility of our optimized polymer PHV design and brings polymeric valves closer to clinical viability. PMID:23445066

Antithrombotic therapy in atrial fibrillation associated with valvular heart disease: a joint consensus document from the European Heart Rhythm Association (EHRA) and European Society of Cardiology Working Group on Thrombosis, endorsed by the ESC Working Group on Valvular Heart Disease, Cardiac Arrhythmia Society of Southern Africa (CASSA), Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), South African Heart (SA Heart) Association and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE).

PubMed

Lip, Gregory Y H; Collet, Jean Philippe; Caterina, Raffaele de; Fauchier, Laurent; Lane, Deirdre A; Larsen, Torben B; Marin, Francisco; Morais, Joao; Narasimhan, Calambur; Olshansky, Brian; Pierard, Luc; Potpara, Tatjana; Sarrafzadegan, Nizal; Sliwa, Karen; Varela, Gonzalo; Vilahur, Gemma; Weiss, Thomas; Boriani, Giuseppe; Rocca, Bianca

2017-11-01

Atrial fibrillation (AF) is a major worldwide public health problem, and AF in association with valvular heart disease (VHD) is also common. However, management strategies for this group of patients have been less informed by randomized trials, which have largely focused on 'non-valvular AF' patients. Thrombo-embolic risk also varies according to valve lesion and may also be associated with CHA2DS2VASc score risk factor components, rather than only the valve disease being causal. Given marked heterogeneity in the definition of valvular and non-valvular AF and variable management strategies, including non-vitamin K antagonist oral anticoagulants (NOACs) in patients with VHD other than prosthetic heart valves or haemodynamically significant mitral valve disease, there is a need to provide expert recommendations for professionals participating in the care of patients presenting with AF and associated VHD. To address this topic, a Task Force was convened by the European Heart Rhythm Association (EHRA) and European Society of Cardiology (ESC) Working Group on Thrombosis, with representation from the ESC Working Group on Valvular Heart Disease, Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), South African Heart (SA Heart) Association and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE) with the remit to comprehensively review the published evidence, and to publish a joint consensus document on the management of patients with AF and associated VHD, with up-to-date consensus recommendations for clinical practice for different forms of VHD. This consensus document proposes that the term 'valvular AF' is outdated and given that any definition ultimately relates to the evaluated practical use of oral anticoagulation (OAC) type, we propose a functional Evaluated Heartvalves, Rheumatic or Artificial (EHRA) categorization in relation to the type of OAC use in patients with AF, as follows: (i) EHRA Type 1 VHD, which refers to AF patients with 'VHD needing therapy with a Vitamin K antagonist (VKA); and (ii) EHRA Type 2 VHD, which refers to AF patients with 'VHD needing therapy with a VKA or a Non-VKA oral anticoagulant (NOAC)', also taking into consideration CHA2DS2VASc score risk factor components. This consensus document also summarizes current developments in the field, and provides general recommendations for the management of these patients based on the principles of evidence-based medicine. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

What Pacemakers Can Teach Us about the Ethics of Maintaining Artificial Organs.

PubMed

Hutchison, Katrina; Sparrow, Robert

2016-11-01

One day soon it may be possible to replace a failing heart, liver, or kidney with a long-lasting mechanical replacement or perhaps even with a 3-D printed version based on the patient's own tissue. Such artificial organs could make transplant waiting lists and immunosuppression a thing of the past. Supposing that this happens, what will the ongoing care of people with these implants involve? In particular, how will the need to maintain the functioning of artificial organs over an extended period affect patients and their doctors and the responsibilities of those who manufacture such devices? Drawing on lessons from the history of the cardiac pacemaker, this article offers an initial survey of the ethical issues posed by the need to maintain and service artificial organs. We briefly outline the nature and history of cardiac pacemakers, with a particular focus on the need for technical support, maintenance, and replacement of these devices. Drawing on the existing medical literature and on our conversations and correspondence with cardiologists, regulators, and manufacturers, we describe five sources of ethical issues associated with pacemaker maintenance: the location of the devices inside the human body, such that maintenance generates surgical risks; the complexity of the devices, which increases the risk of harms to patients as well as introducing potential injustices in access to treatment; the role of software-particularly software that can be remotely accessed-in the functioning of the devices, which generates privacy and security issues; the impact of continual development and improvement of the device; and the influence of commercial interests in the context of a medical device market in which there are several competing products. Finally, we offer some initial suggestions as to how these questions should be answered. © 2016 The Hastings Center.

A novel paradigm for telemedicine using the personal bio-monitor.

PubMed

Bhatikar, Sanjay R; Mahajan, Roop L; DeGroff, Curt

2002-01-01

The foray of solid-state technology in the medical field has yielded an arsenal of sophisticated healthcare tools. Personal, portable computing power coupled with the information superhighway open up the possibility of sophisticated healthcare management that will impact the medical field just as much. The full synergistic potential of three interwoven technologies: (1) compact electronics, (2) World Wide Web, and (3) Artificial Intelligence is yet to be realized. The system presented in this paper integrates these technologies synergistically, providing a new paradigm for healthcare. Our idea is to deploy internet-enabled, intelligent, handheld personal computers for medical diagnosis. The salient features of the 'Personal Bio-Monitor' we envisage are: (1) Utilization of the peripheral signals of the body which may be acquired non-invasively and with ease, for diagnosis of medical conditions; (2) An Artificial Neural Network (ANN) based approach for diagnosis; (3) Configuration of the diagnostic device as a handheld for personal use; (4) Internet connectivity, following the emerging bluetooth protocol, for prompt conveyance of information to a patient's health care provider via the World Wide Web. The proposal is substantiated with an intelligent handheld device developed by the investigators for pediatric cardiac auscultation. This device performed accurate diagnoses of cardiac abnormalities in pediatrics using an artificial neural network to process heart sounds acquired by a low-frequency microphone and transmitted its diagnosis to a desktop PC via infrared. The idea of the personal biomonitor presented here has the potential to streamline healthcare by optimizing two valuable resources: physicians' time and sophisticated equipment time. We show that the elements of such a system are in place, with our prototype. Our novel contribution is the synergistic integration of compact electronics' technology, artificial neural network methodology and the wireless web resulting in a revolutionary new paradigm for healthcare management.

Artificial Gravity as a Multi-System Countermeasure to Bed Rest Deconditioning: Preliminary Results

NASA Technical Reports Server (NTRS)

Warren, L. E.; Paloski, William H.; Young, L. R.

2006-01-01

Artificial gravity paradigms may offer effective, efficient, multi-system protection from the untoward effects of adaptation to the microgravity of space or the hypogravity of planetary surfaces. Intermittent artificial gravity (AG) produced by a horizontal short-radius centrifuge (SRC) has recently been utilized on human test subjects deconditioned by bed rest. This presentation will review preliminary results of a 41 day study conducted at the University of Texas Medical Branch, Galveston, TX bed rest facility. During the first eleven days of the protocol, subjects were ambulatory, but confined to the facility. They began a carefully controlled diet, and participated in multiple baseline tests of bone, muscle, cardiovascular, sensory-motor, immunological, and psychological function. On the twelfth day, subjects entered the bed rest phase of the study, during which they were confined to strict 6deg head down tilt bed rest for 21 days. Beginning 24 hrs into this period, treatment subjects received one hour daily exposures to artificial gravity which was produced by spinning the subjects on a 3.0 m radius SRC. They were oriented radially in the supine position so that the centrifugal force was aligned with their long body axis, and while spinning, they "stood" on a force plate, supporting the centrifugal loading (2.5 g at the feet, 1.0 g at the heart). The subject station allowed free translation over approximately 10 cm to ensure full loading of the lower extremities and to allow for anti-orthostatic muscle contractions. Control subjects were positioned on the centrifuge but did not spin. Following the bed rest phase, subjects were allowed to ambulate again, but remained within the facility for an additional 9 days and participated in multiple follow-up tests of physiological function.

Role of the autonomic nervous system in the control of heart rate and blood pressure in the defence reaction in conscious dogs.

PubMed

Federici, A; Rizzo, A; Cevese, A

1985-04-01

The present study was performed on conscious, chronically instrumented dogs, which underwent selective blockade of sympathetic adrenergic and vagal outflows. Excitements were performed on these animals in normal states (N), after chronic treatment with guanethidine, for sympathetic blockade (SB), after cold vagal blockade (VB), and after combined sympathetic and vagal blockade (SB + VB). Heart rate and arterial blood pressure were monitored in all the experiments, while a group of dogs was also tested with an electromagnetic flowmeter on the superior mesenteric artery. The role of the sympathetic and parasympathetic controls in the defence reaction was assumed from comparison of experiments performed in the presence or in the absence of each (or both) autonomic component(s). In the SB + VB condition, excitement was followed by sudden hypotension, without changes in heart rate. In VB experiments, a brief and transient hypotension appeared, followed by gradually developed hypertension, while heart rate progressively rose in about 5 s; there was no sudden increase in mesenteric vascular resistance, which contrasted with the very marked reaction in N experiments. Under vagal control alone (SB), the stimulus elicited prompt tachycardia and hypertension, followed by a period of moderately reduced blood pressure. We conclude that, while the defence reaction leads to a sudden fall of arterial blood pressure, in the absence of compensatory mechanisms, both branches of the autonomic nervous system play a protective role against hypotension. In addition, the modulation of the vagal outflow, leading to sudden changes in the heart performance, seems to be responsible for the initiation of the overall haemodynamic adjustments following excitements. The possibility that withdrawal of the parasympathetic outflow to the heart may raise arterial blood pressure was verified in a special experiment in which artificial vagal stimulation in a conscious (vagal blocked) dog, was turned off for brief periods, before and after guanethidine. This led to changes in blood pressure and heart rate very similar to those seen at the onset of the defence reaction, both in N and SB conditions.

Cardiac arrest: resuscitation and reperfusion.

PubMed

Patil, Kaustubha D; Halperin, Henry R; Becker, Lance B

2015-06-05

The modern treatment of cardiac arrest is an increasingly complex medical procedure with a rapidly changing array of therapeutic approaches designed to restore life to victims of sudden death. The 2 primary goals of providing artificial circulation and defibrillation to halt ventricular fibrillation remain of paramount importance for saving lives. They have undergone significant improvements in technology and dissemination into the community subsequent to their establishment 60 years ago. The evolution of artificial circulation includes efforts to optimize manual cardiopulmonary resuscitation, external mechanical cardiopulmonary resuscitation devices designed to augment circulation, and may soon advance further into the rapid deployment of specially designed internal emergency cardiopulmonary bypass devices. The development of defibrillation technologies has progressed from bulky internal defibrillators paddles applied directly to the heart, to manually controlled external defibrillators, to automatic external defibrillators that can now be obtained over-the-counter for widespread use in the community or home. But the modern treatment of cardiac arrest now involves more than merely providing circulation and defibrillation. As suggested by a 3-phase model of treatment, newer approaches targeting patients who have had a more prolonged cardiac arrest include treatment of the metabolic phase of cardiac arrest with therapeutic hypothermia, agents to treat or prevent reperfusion injury, new strategies specifically focused on pulseless electric activity, which is the presenting rhythm in at least one third of cardiac arrests, and aggressive post resuscitation care. There are discoveries at the cellular and molecular level about ischemia and reperfusion pathobiology that may be translated into future new therapies. On the near horizon is the combination of advanced cardiopulmonary bypass plus a cocktail of multiple agents targeted at restoration of normal metabolism and prevention of reperfusion injury, as this holds the promise of restoring life to many patients for whom our current therapies fail. © 2015 American Heart Association, Inc.

Electrically contractile polymers augment right ventricular output in the heart.

PubMed

Ruhparwar, Arjang; Piontek, Patricia; Ungerer, Matthias; Ghodsizad, Ali; Partovi, Sasan; Foroughi, Javad; Szabo, Gabor; Farag, Mina; Karck, Matthias; Spinks, Geoffrey M; Kim, Seon Jeong

2014-12-01

Research into the development of artificial heart muscle has been limited to assembly of stem cell-derived cardiomyocytes seeded around a matrix, while nonbiological approaches to tissue engineering have rarely been explored. The aim of the study was to apply electrically contractile polymer-based actuators as cardiomyoplasty for positive inotropic support of the right ventricle. Complex trilayer polypyrrole (PPy) bending polymers for high-speed applications were generated. Bending motion occurred directly as a result of electrochemically driven charging and discharging of the PPy layers. In a rat model (n = 5), strips of polymers (3 × 20 mm) were attached and wrapped around the right ventricle (RV). RV pressure was continuously monitored invasively by direct RV cannulation. Electrical activation occurred simultaneously with either diastole (in order to evaluate the polymer's stand-alone contraction capacity; group 1) or systole (group 2). In group 1, the pressure generation capacity of the polymers was measured by determining the area under the pressure curve (area under curve, AUC). In group 2, the RV pressure AUC was measured in complexes directly preceding those with polymer contraction and compared to RV pressure complexes with simultaneous polymer contraction. In group 1, the AUC generated by polymer contraction was 2768 ± 875 U. In group 2, concomitant polymer contraction significantly increased AUC compared with complexes without polymer support (5987 ± 1334 U vs. 4318 ± 691 U, P ≤ 0.01). Electrically contractile polymers are able to significantly augment right ventricular contraction. This approach may open new perspectives for myocardial tissue engineering, possibly in combination with fetal or embryonic stem cell-derived cardiomyocytes. Copyright © 2014 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Totally implantable total artificial heart and ventricular assist device with multipurpose miniature electromechanical energy system.

PubMed

Takatani, S; Orime, Y; Tasai, K; Ohara, Y; Naito, K; Mizuguchi, K; Makinouchi, K; Damm, G; Glueck, J; Ling, J

1994-01-01

A multipurpose miniature electromechanical energy system has been developed to yield a compact, efficient, durable, and biocompatible total artificial heart (TAH) and ventricular assist device (VAD). Associated controller-driver electronics were recently miniaturized and converted into hybrid circuits. The hybrid controller consists of a microprocessor and controller, motor driver, Hall sensor, and commutation circuit hybrids. The sizing study demonstrated that all these components can be incorporated in the pumping unit of the TAH and VAD, particularly in the centerpiece of the TAH and the motor housing of the VAD. Both TAH and VAD pumping units will start when their power line is connected to either the internal power pack or the external battery unit. As a redundant driving and diagnostic port, an emergency port was newly added and will be placed in subcutaneous location. In case of system failure, the skin will be cut down, and an external motor drive or a pneumatic driver will be connected to this port to run the TAH. This will minimize the circulatory arrest time. Overall efficiency of the TAH without the transcutaneous energy transmission system was 14-18% to deliver pump outputs of 4-9 L/min against the right and left afterload pressures of 25 and 100 mm Hg. The internal power requirement ranged from 6 to 13 W. The rechargeable batteries such as NiCd or NiMH with 1 AH capacity can run the TAH for 30-45 min. The external power requirement, when TETS efficiency of 75% was assumed, ranged from 8 to 18 W. The accelerated endurance test in the 42 degrees C saline bath demonstrated stable performance over 4 months. Long-term endurance and chronic animal studies will continue toward a system with 5 years durability by the year 2000.

Development of a precise controller for an electrohydraulic total artificial heart. Improvement of the motor's dynamic response.

PubMed

Ahn, J M; Masuzawa, T; Taenaka, Y; Tatsumi, E; Ohno, T; Choi, W W; Toda, K; Miyazaki, K; Baba, Y; Nakatani, T; Takano, H; Min, B G

1996-01-01

In an electrohydraulic total artificial heart developed at the National Cardiovascular Center (Osaka, Japan), two blood pumps are pushed alternatively by means of the bidirectional motion of a brushless DC motor for pump systole and diastole. Improvement in the dynamic response of the motor is very important to obtain better pump performance; this was accomplished by using power electronic simulation. For the motor to have the desired dynamic response, it must be commutated properly and the damping ratio (zeta), which represents transient characteristics of the motor, must lie between 0.4 and 0.8. Consequently, all satisfactory specifications with respect to power consumption must be obtained. Based on the simulated results, the design criteria were determined and the precise controller designed to reduce torque ripple and motor vibration, and determine motor stop time at every direction change. In in vitro tests, evaluation of the controller and dynamic response of the motor was justified in terms of zeta, power consumption, and motor stop time. The results indicated that the power consumption of the controller and the input power of the motor were decreased by 1.2 and 2.5 W at zeta = 0.6, respectively, compared to the previous system. An acceptable dynamic response of the motor, necessary for the reduction of torque ripple and motor vibration, was obtained between zeta = 0.5 and zeta = 0.7, with an increase in system efficiency from 10% to 12%. The motor stop time required for stable motor reoperation was determined to be over 10 msec, for a savings in power consumption of approximately 1.5 W. Therefore, the improved dynamic response of the motor can contribute to the stability and reliability of the pump.

Analysis, design, and control of a transcutaneous power regulator for artificial hearts.

PubMed

Qianhong Chen; Siu Chung Wong; Tse, C K; Xinbo Ruan

2009-02-01

Based on a generic transcutaneous transformer model, a remote power supply using a resonant topology for use in artificial hearts is analyzed and designed for easy controllability and high efficiency. The primary and secondary windings of the transcutaneous transformer are positioned outside and inside the human body, respectively. In such a transformer, the alignment and gap may change with external positioning. As a result, the coupling coefficient of the transcutaneous transformer is also varying, and so are the two large leakage inductances and the mutual inductance. Resonant-tank circuits with varying resonant-frequency are formed from the transformer inductors and external capacitors. For a given range of coupling coefficients, an operating frequency corresponding to a particular coupling coefficient can be found, for which the voltage transfer function is insensitive to load. Prior works have used frequency modulation to regulate the output voltage under varying load and transformer coupling. The use of frequency modulation may require a wide control frequency range which may extend well above the load insensitive frequency. In this paper, study of the input-to-output voltage transfer function is carried out, and a control method is proposed to lock the switching frequency at just above the load insensitive frequency for optimized efficiency at heavy loads. Specifically, operation at above resonant of the resonant circuits is maintained under varying coupling-coefficient. Using a digital-phase-lock-loop (PLL), zero-voltage switching is achieved in a full-bridge converter which is also programmed to provide output voltage regulation via pulsewidth modulation (PWM). A prototype transcutaneous power regulator is built and found to to perform excellently with high efficiency and tight regulation under variations of the alignment or gap of the transcutaneous transformer, load and input voltage.

Mitral valve repair in dogs using an ePTFE chordal implantation device: a pilot study.

PubMed

Borgarelli, M; Lanz, O; Pavlisko, N; Abbott, J A; Menciotti, G; Aherne, M; Lahmers, S M; Lahmers, K K; Gammie, J S

2017-06-01

Mitral valve (MV) regurgitation due to degenerative MV disease is the leading cause of cardiac death in dogs. We carried out preliminary experiments to determine the feasibility and short-term effects of beating-heart MV repair using an expanded polytetrafluorethylene (ePTFE) chordal implantation device (Harpoon TSD-5) in dogs. This study involved six healthy purpose-bred Beagles (weight range 8.9-11.4 kg). Following a mini-thoracotomy performed under general anesthesia, the TSD-5 was used to place 1 or 2 artificial ePTFE cords on the anterior MV leaflet or the posterior MV leaflet via a left-ventricular transapical approach. The procedure was guided and monitored by transesophageal echocardiography. Postoperative antithrombotic treatment consisted of clopidogrel or a combination of clopidogrel and apixaban. Dogs were serially evaluated by transthoracic echocardiography at day 1, 7, 14, 21, and 30. The hearts were then examined for evaluation of tissues reactions and to detect signs of endothelialization. One or two chords were successfully implanted in five dogs. Four dogs completed the 30 days follow-up. One dog died intra-operatively because of aortic perforation. One dog died early post-operatively from a hemorrhagic pleural effusion attributed to overly aggressive antithrombotic treatment. One dog developed a thrombus surrounding both the knot and the synthetic cord. Postmortem exam confirmed secure placement of ePTFE knots in the mitral leaflets in all dogs and the presence of endothelialization of the knots and chords. These preliminary results demonstrate the feasibility of artificial chordal placement using an ePTFE cordal implantation device in dogs. Copyright © 2017 Elsevier B.V. All rights reserved.

First Report of 90-Day Support of Two Calves with a Continuous-Flow Total Artificial Heart

PubMed Central

Karimov, Jamshid H.; Moazami, Nader; Kobayashi, Mariko; Sale, Shiva; Such, Kimberly; Byram, Nicole; Sunagawa, Gengo; Horvath, David; Gao, Shengqiang; Kuban, Barry; Golding, Leonard A.; Fukamachi, Kiyotaka

2015-01-01

Objective The Cleveland Clinic continuous-flow total artificial heart (CFTAH) is a compact, single-piece, valveless, pulsatile pump providing self-regulated hemodynamic output to left/right circulation. We evaluated chronic in vivo pump performance, physiologic and hemodynamic parameters, and biocompatibility of the CFTAH in a well-established calf model. Methods CFTAH pumps have been implanted in 17 calves total. Hemodynamics, pump performance, and device-related adverse events were evaluated during studies and at necropsy. Results In vivo experiments demonstrated good hemodynamic performance (pump flow, 7.3 ± 0.7 L/min; left atrial pressure [LAP], 16 ± 3 mm Hg; right atrial pressure [RAP], 17 ± 3 mm Hg; RAP-LAP difference, 1 ± 2 mm Hg; mean arterial pressure, 103 ± 7 mm Hg; arterial pulse pressure, 30 ± 11 mm Hg; pulmonary arterial pressure, 34 ± 5 mm Hg). The CFTAH has operated within design specifications and never failed. With ever-improving pump design, the implants have shown no chronic hemolysis. Three recent animals with the CFTAH recovered well, with no postoperative anticoagulation, during planned in vivo durations of 30, 90, and 90 days (last two were intended to be 90-day studies). All these longest-surviving cases showed good biocompatibility, with no thromboembolism in organs. Conclusions The current CFTAH has demonstrated reliable self-regulation of hemodynamic output and acceptable biocompatibility without anticoagulation throughout 90 days of chronic implantation in calves. Meeting these milestones is in accord with our strategy to achieve transfer of this unique technology to surgical practice, thus filling the urgent need for cardiac replacement devices as destination therapy. PMID:26173607

Modified high-density lipoproteins by artificial sweetener, aspartame, and saccharin, showed loss of anti-atherosclerotic activity and toxicity in zebrafish.

PubMed

Kim, Jae-Yong; Park, Ki-Hoon; Kim, Jihoe; Choi, Inho; Cho, Kyung-Hyun

2015-01-01

Safety concerns have been raised regarding the association of chronic consumption of artificial sweeteners (ASs) with metabolic disorders, especially in the heart and brain. There has been no information on the in vivo physiological effects of AS consumption in lipoprotein metabolism. High-dosage treatment (final 25, 50, and 100 mM) with AS (aspartame, acesulfame K, and saccharin) to human high-density lipoprotein (HDL) induced loss of antioxidant ability along with elevated atherogenic effects. Aspartame-treated HDL3 (final 100 mM) almost all disappeared due to putative proteolytic degradation. Aspartame- and saccharin-treated HDL3 showed more enhanced cholesteryl ester transfer activity, while their antioxidant ability was disappeared. Microinjection of the modified HDL3 exacerbated the inflammatory death in zebrafish embryos in the presence of oxLDL. These results show that AS treatment impaired the beneficial functions of HDL, resulting in loss of antioxidant and anti-atherogenic activities. These results suggest that aspartame and saccharin could be toxic to the human circulation system as well as embryonic development via impairment of lipoprotein function.

Improved artificial saliva for studying the cariogenic effect of carbohydrates.

PubMed

Björklund, Marika; Ouwehand, Arthur C; Forssten, Sofia D

2011-07-01

Saliva is a complex fluid that possesses many important functions regarding oral health. Many in vitro studies require relatively large quantities of saliva. While natural saliva would be the material of choice, it is difficult to obtain in sufficient quantities and varies in composition. Substitutes mimicking the physicochemical properties of saliva have been developed, but these are not appropriate to study the growth of mutans streptococci. Brain Heart Infusion (BHI) has been commonly used for this, but this medium is richer in nutrients than saliva. We therefore developed artificial saliva (AS) with nutrient levels resembling those in natural saliva as a substitute for natural human saliva (HS) to study the influence of different carbon sources on mutans streptococci growth. Growth of a wild-type Streptococcus mutans strain and S. mutans ATCC 15175 in BHI, HS, and AS was monitored anaerobically. Growth of S. mutans in the modified AS was very similar to the growth in HS, both in the absence and presence of different carbon sources. We therefore conclude that the developed AS is suitable for in vitro tests on S. mutans growth.

Mercury Exposure and Heart Diseases

PubMed Central

Genchi, Giuseppe; Sinicropi, Maria Stefania; Carocci, Alessia; Lauria, Graziantonio; Catalano, Alessia

2017-01-01

Environmental contamination has exposed humans to various metal agents, including mercury. It has been determined that mercury is not only harmful to the health of vulnerable populations such as pregnant women and children, but is also toxic to ordinary adults in various ways. For many years, mercury was used in a wide variety of human activities. Nowadays, the exposure to this metal from both natural and artificial sources is significantly increasing. Recent studies suggest that chronic exposure, even to low concentration levels of mercury, can cause cardiovascular, reproductive, and developmental toxicity, neurotoxicity, nephrotoxicity, immunotoxicity, and carcinogenicity. Possible biological effects of mercury, including the relationship between mercury toxicity and diseases of the cardiovascular system, such as hypertension, coronary heart disease, and myocardial infarction, are being studied. As heart rhythm and function are under autonomic nervous system control, it has been hypothesized that the neurotoxic effects of mercury might also impact cardiac autonomic function. Mercury exposure could have a long-lasting effect on cardiac parasympathetic activity and some evidence has shown that mercury exposure might affect heart rate variability, particularly early exposures in children. The mechanism by which mercury produces toxic effects on the cardiovascular system is not fully elucidated, but this mechanism is believed to involve an increase in oxidative stress. The exposure to mercury increases the production of free radicals, potentially because of the role of mercury in the Fenton reaction and a reduction in the activity of antioxidant enzymes, such as glutathione peroxidase. In this review we report an overview on the toxicity of mercury and focus our attention on the toxic effects on the cardiovascular system. PMID:28085104

Mercury Exposure and Heart Diseases.

PubMed

Genchi, Giuseppe; Sinicropi, Maria Stefania; Carocci, Alessia; Lauria, Graziantonio; Catalano, Alessia

2017-01-12

Environmental contamination has exposed humans to various metal agents, including mercury. It has been determined that mercury is not only harmful to the health of vulnerable populations such as pregnant women and children, but is also toxic to ordinary adults in various ways. For many years, mercury was used in a wide variety of human activities. Nowadays, the exposure to this metal from both natural and artificial sources is significantly increasing. Recent studies suggest that chronic exposure, even to low concentration levels of mercury, can cause cardiovascular, reproductive, and developmental toxicity, neurotoxicity, nephrotoxicity, immunotoxicity, and carcinogenicity. Possible biological effects of mercury, including the relationship between mercury toxicity and diseases of the cardiovascular system, such as hypertension, coronary heart disease, and myocardial infarction, are being studied. As heart rhythm and function are under autonomic nervous system control, it has been hypothesized that the neurotoxic effects of mercury might also impact cardiac autonomic function. Mercury exposure could have a long-lasting effect on cardiac parasympathetic activity and some evidence has shown that mercury exposure might affect heart rate variability, particularly early exposures in children. The mechanism by which mercury produces toxic effects on the cardiovascular system is not fully elucidated, but this mechanism is believed to involve an increase in oxidative stress. The exposure to mercury increases the production of free radicals, potentially because of the role of mercury in the Fenton reaction and a reduction in the activity of antioxidant enzymes, such as glutathione peroxidase. In this review we report an overview on the toxicity of mercury and focus our attention on the toxic effects on the cardiovascular system.

Mechanisms of action of sacubitril/valsartan on cardiac remodeling: a systems biology approach.

PubMed

Iborra-Egea, Oriol; Gálvez-Montón, Carolina; Roura, Santiago; Perea-Gil, Isaac; Prat-Vidal, Cristina; Soler-Botija, Carolina; Bayes-Genis, Antoni

2017-01-01

Sacubitril/Valsartan, proved superiority over other conventional heart failure management treatments, but its mechanisms of action remains obscure. In this study, we sought to explore the mechanistic details for Sacubitril/Valsartan in heart failure and post-myocardial infarction remodeling, using an in silico, systems biology approach. Myocardial transcriptome obtained in response to myocardial infarction in swine was analyzed to address post-infarction ventricular remodeling. Swine transcriptome hits were mapped to their human equivalents using Reciprocal Best (blast) Hits, Gene Name Correspondence, and InParanoid database. Heart failure remodeling was studied using public data available in gene expression omnibus (accession GSE57345, subseries GSE57338), processed using the GEO2R tool. Using the Therapeutic Performance Mapping System technology, dedicated mathematical models trained to fit a set of molecular criteria, defining both pathologies and including all the information available on Sacubitril/Valsartan, were generated. All relationships incorporated into the biological network were drawn from public resources (including KEGG, REACTOME, INTACT, BIOGRID, and MINT). An artificial neural network analysis revealed that Sacubitril/Valsartan acts synergistically against cardiomyocyte cell death and left ventricular extracellular matrix remodeling via eight principal synergistic nodes. When studying each pathway independently, Valsartan was found to improve cardiac remodeling by inhibiting members of the guanine nucleotide-binding protein family, while Sacubitril attenuated cardiomyocyte cell death, hypertrophy, and impaired myocyte contractility by inhibiting PTEN. The complex molecular mechanisms of action of Sacubitril/Valsartan upon post-myocardial infarction and heart failure cardiac remodeling were delineated using a systems biology approach. Further, this dataset provides pathophysiological rationale for the use of Sacubitril/Valsartan to prevent post-infarct remodeling.

Real-world applications of artificial neural networks to cardiac monitoring using radar and recent theoretical developments

NASA Astrophysics Data System (ADS)

Padgett, Mary Lou; Johnson, John L.; Vemuri, V. Rao

1997-04-01

This paper focuses on use of a new image filtering technique, Pulsed Coupled Neural Network factoring to enhance both the analysis and visual interpretation of noisy sinusoidal time signals, such as those produced by LLNL's Microwave Impulse Radar motion sensor. Separation of a slower, carrier wave from faster, finer detailed signals and from scattered noise is illustrated. The resulting images clearly illustrate the changes over time of simulated heart motion patterns. Such images can potentially assist a field medic in interpretation of the extent of combat injuries. These images can also be transmitted or stored and retrieved for later analysis.

Ion beam sputter modification of the surface morphology of biological implants

NASA Technical Reports Server (NTRS)

Weigand, A. J.; Banks, B. A.

1976-01-01

The surface chemistry and texture of materials used for biological implants may significantly influence their performance and biocompatibility. Recent interest in the microscopic control of implant surface texture has led to the evaluation of ion beam sputtering as a potentially useful surface roughening technique. Ion sources, similar to electron bombardment ion thrusters designed for propulsive applications, are used to roughen the surfaces of various biocompatible alloys or polymer materials. These materials are typically used for dental implants, orthopedic prostheses, vascular prostheses, and artificial heart components. Masking techniques and resulting surface textures are described along with progress concerning evaluation of the biological response to the ion beam sputtered surfaces.

Ion-beam-sputter modification of the surface morphology of biological implants

NASA Technical Reports Server (NTRS)

Weigand, A. J.; Banks, B. A.

1977-01-01

The surface chemistry and texture of materials used for biological implants may significantly influence their performance and biocompatibility. Recent interest in the microscopic control of implant surface texture has led to the evaluation of ion-beam sputtering as a potentially useful surface roughening technique. Ion sources, similar to electron-bombardment ion thrusters designed for propulsive applications, are used to roughen the surfaces of various biocompatible alloys or polymer materials. These materials are typically used for dental implants, orthopedic prostheses, vascular prostheses, and artificial heart components. Masking techniques and resulting surface textures are described along with progress concerning evaluation of the biological response to the ion-beam-sputtered surfaces.

In vivo vascular flow profiling combined with optical tweezers based blood routing

NASA Astrophysics Data System (ADS)

Meissner, Robert; Sugden, Wade W.; Siekmann, Arndt F.; Denz, Cornelia

2017-07-01

In vivo wall shear rate is quantified during zebrafish development using particle image velocimetry for biomedical diagnosis and modeling of artificial vessels. By using brightfield microscopy based high speed video tracking we can resolve single heart-beat cycles of blood flow in both space and time. Maximum blood flow velocities and wall shear rates are presented for zebrafish at two and three days post fertilization. By applying biocompatible optical tweezers as an Optical rail we present rerouting of red blood cells in vivo. With purely light-driven means we are able to compensate the lack of proper red blood cell blood flow in so far unperfused capillaries.

Pediatric Artificial Lung: A Low-Resistance Pumpless Artificial Lung Alleviates an Acute Lamb Model of Increased Right Ventricle Afterload.

PubMed

Alghanem, Fares; Bryner, Benjamin S; Jahangir, Emilia M; Fernando, Uditha P; Trahanas, John M; Hoffman, Hayley R; Bartlett, Robert H; Rojas-Peña, Alvaro; Hirschl, Ronald B

Lung disease in children often results in pulmonary hypertension and right heart failure. The availability of a pediatric artificial lung (PAL) would open new approaches to the management of these conditions by bridging to recovery in acute disease or transplantation in chronic disease. This study investigates the efficacy of a novel PAL in alleviating an animal model of pulmonary hypertension and increased right ventricle afterload. Five juvenile lambs (20-30 kg) underwent PAL implantation in a pulmonary artery to left atrium configuration. Induction of disease involved temporary, reversible occlusion of the right main pulmonary artery. Hemodynamics, pulmonary vascular input impedance, and right ventricle efficiency were measured under 1) baseline, 2) disease, and 3) disease + PAL conditions. The disease model altered hemodynamics variables in a manner consistent with pulmonary hypertension. Subsequent PAL attachment improved pulmonary artery pressure (p = 0.018), cardiac output (p = 0.050), pulmonary vascular input impedance (Z.0 p = 0.028; Z.1 p = 0.058), and right ventricle efficiency (p = 0.001). The PAL averaged resistance of 2.3 ± 0.8 mm Hg/L/min and blood flow of 1.3 ± 0.6 L/min. This novel low-resistance PAL can alleviate pulmonary hypertension in an acute animal model and demonstrates potential for use as a bridge to lung recovery or transplantation in pediatric patients with significant pulmonary hypertension refractory to medical therapies.

First artificial hybrid of the eel species Anguilla australis and Anguilla anguilla.

PubMed

Burgerhout, Erik; Brittijn, Sebastiaan A; Kurwie, Tagried; Decker, Paul; Dirks, Ron P; Palstra, Arjan P; Spaink, Herman P; Van den Thillart, Guido E E J M

2011-03-13

Studies on artificial hybridization of different Anguilla species were conducted recently, i.e. female A. australis with male A. dieffenbachii, and female A. japonica with male A. anguilla. The existence of these artificial hybrids was however not demonstrated by independent genetic methods. Two species - A. anguilla and A. australis - that are phylogenetically close but have different sexual maturation times (12-25 weeks and 6-8 weeks, respectively), were expected to produce favourable hybrids for reproduction studies. A modification of the protocol for the reproduction of Anguilla japonica was used to produce eight-day Anguilla australis larvae, with a success rate of 71.4%. Thus ten out of 14 females produced eggs that could be fertilized, and three batches resulted in mass hatching. Hybrid larvae from female A. australis x male A. Anguilla survived for up to seven days post fertilization (dpf). The early development of the hybrid showed typical characteristics of A. anguilla tail pigmentation at 50 hours post fertilization (hpf), indicating expression of genes derived from the father. In this paper we describe the first production of hybrid larvae from male A. anguilla and female A. australis and their survival for up to 7 dpf. A species-specific nucleotide difference in the 18 S rDNA gene confirmed that genes from both A. australis and A. anguilla were present in the hybrids. The developmental stages of the hybrid eel embryos and larvae are described using high resolution images. Video footage also indicated a heart beat in 5-dpf larva.

Multi-agent system as a new approach to effective chronic heart failure management: key considerations.

PubMed

Mohammadzadeh, Niloofar; Safdari, Reza; Rahimi, Azin

2013-09-01

Given the importance of the follow-up of chronic heart failure (CHF) patients to reduce common causes of re-admission and deterioration of their status that lead to imposing spiritual and physical costs on patients and society, modern technology tools should be used to the best advantage. The aim of this article is to explain key points which should be considered in designing an appropriate multi-agent system to improve CHF management. In this literature review articles were searched with keywords like multi-agent system, heart failure, chronic disease management in Science Direct, Google Scholar and PubMed databases without regard to the year of publications. Agents are an innovation in the field of artificial intelligence. Because agents are capable of solving complex and dynamic health problems, to take full advantage of e-Health, the healthcare system must take steps to make use of this technology. Key factors in CHF management through a multi-agent system approach must be considered such as organization, confidentiality in general aspects and design and architecture points in specific aspects. Note that use of agent systems only with a technical view is associated with many problems. Hence, in delivering healthcare to CHF patients, considering social and human aspects is essential. It is obvious that identifying and resolving technical and non-technical challenges is vital in the successful implementation of this technology.

Multi-Agent System as a New Approach to Effective Chronic Heart Failure Management: Key Considerations

PubMed Central

Mohammadzadeh, Niloofar; Rahimi, Azin

2013-01-01

Objectives Given the importance of the follow-up of chronic heart failure (CHF) patients to reduce common causes of re-admission and deterioration of their status that lead to imposing spiritual and physical costs on patients and society, modern technology tools should be used to the best advantage. The aim of this article is to explain key points which should be considered in designing an appropriate multi-agent system to improve CHF management. Methods In this literature review articles were searched with keywords like multi-agent system, heart failure, chronic disease management in Science Direct, Google Scholar and PubMed databases without regard to the year of publications. Results Agents are an innovation in the field of artificial intelligence. Because agents are capable of solving complex and dynamic health problems, to take full advantage of e-Health, the healthcare system must take steps to make use of this technology. Key factors in CHF management through a multi-agent system approach must be considered such as organization, confidentiality in general aspects and design and architecture points in specific aspects. Conclusions Note that use of agent systems only with a technical view is associated with many problems. Hence, in delivering healthcare to CHF patients, considering social and human aspects is essential. It is obvious that identifying and resolving technical and non-technical challenges is vital in the successful implementation of this technology. PMID:24195010

Total heart replacement using dual intracorporeal continuous-flow pumps in a chronic bovine model: a feasibility study.

PubMed

Frazier, O H; Tuzun, Egemen; Cohn, William E; Conger, Jeffrey L; Kadipasaoglu, Kamuran A

2006-01-01

Continuous-flow pumps are small, simple, and respond physiologically to input variations, making them potentially ideal for total heart replacement. However, the physiological effects of complete pulseless flow during long-term circulatory support without a cardiac interface or with complete cardiac exclusion have not been well studied. We evaluated the feasibility of dual continuous-flow pumps as a total artificial heart (TAH) in a chronic bovine model. Both ventricles of a 6-month-old Corriente crossbred calf were excised and sewing rings attached to the reinforced atrioventricular junctions. The inlet portions of 2 Jarvik 2000 pumps were positioned through their respective sewing rings at the mid-atrial level and the pulseless atrial reservoir connected end-to-end to the pulmonary artery and aorta. Pulseless systemic and pulmonary circulations were thereby achieved. Volume status was controlled, and systemic and pulmonary resistance were managed pharmacologically to keep mean arterial pressures at 100+/-10 mmHg (systemic) and 20+/-5 mmHg (pulmonary) and both left and right atrial pressures at 15+/-5 mmHg. The left pump speed was maintained at 14,000 rpm and its output autoregulated in response to variations in right pump flow, systemic and pulmonary pressures, fluid status, and activity level. Hemodynamics, end-organ function, and neurohormonal status remained normal. These results suggest the feasibility of using dual continuous-flow pumps as a TAH.

[Cardiac cachexia].

PubMed

Miján, Alberto; Martín, Elvira; de Mateo, Beatriz

2006-05-01

Chronic heart failure (CHF), especially affecting the right heart, frequently leads to malnutrition. If the latter is severe and is combined to other factors, it may lead to cardiac cachexia. This one is associated to increased mortality and lower survival of patients suffering from it. The causes of cardiac cachexia are diverse, generally associated to maintenance of a negative energy balance, with increasing evidence of its multifactorial origin. Neurohumoral, inflammatory, immunological, and metabolic factors, among others, are superimposed in the patient with CHF, leading to involvement and deterioration of several organs and systems, since this condition affects both lean (or active cellular) mass and adipose and bone tissue osteoporosis. Among all, the most pronounced deterioration may be seen at skeletal muscle tissue, at both structural and functional levels, the heart not being spared. As for treatment, it should be based on available scientific evidence. Assessment of nutritional status of any patient with CHF is a must, with the requirement of nutritional intervention in case of malnutrition. In this situation, especially if accompanied by cardiac cachexia, it is required to modify energy intake and oral diet quality, and to consider the indication of specific complementary or alternative artificial nutrition. Besides, the causal relationship of the beneficial role of moderate physical exertion is increasing, as well as modulation of metabolic and inflammatory impairments observed in cardiac cachexia with several drugs, leading to a favorable functional and structural response in CHF patients.

Clinical and molecular cytogenetic studies in ring chromosome 5: report of a child with congenital abnormalities.

PubMed

Basinko, Audrey; Giovannucci Uzielli, Maria Luisa; Scarselli, Gloria; Priolo, Manuela; Timpani, Giuseppina; De Braekeleer, Marc

2012-02-01

We report here a child with a ring chromosome 5 (r(5)) associated with facial dysmorphology and multiple congenital abnormalities. Fluorescent in situ hybridization (FISH) using bacterial artificial chromosome (BAC) clones was performed to determine the breakpoints involved in the r(5). The 5p deletion extended from 5p13.2-3 to 5pter and measured 34.61 Mb (range: 33.7-35.52 Mb) while the 5q deletion extended from 5q35.3 to 5qter and measured 2.44 Mb (range: 2.31-2.57 Mb). The patient presented signs such as microcephaly, hypertelorism, micrognathia and epicanthal folds, partially recalling those of a deletion of the short arm of chromosome 5 and the "cri-du-chat" syndrome. The most striking phenotypic features were the congenital heart abnormalities which have been frequently reported in deletions of the distal part of the long arm of chromosome 5 and in rings leading to a 5q35-5qter deletion. However, the NKX2-5 gene, which has been related to congenital heart defects, was not deleted in our patient, nor presumably to some other patients with 5q35.3-5qter deletion. We propose that VEGFR3, deleted in our patient, could be a candidate gene for the congenital heart abnormalities observed. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

A mini axial and a permanent maglev radial heart pump.

PubMed

Qian, Kun-Xi; Ru, Wei-Min; Wang, Hao; Jing, Teng

2007-05-31

The implantability and durability have been for decades the focus of artificial heart R&D. A mini axial and a maglev radial pump have been developed to meet with such requirements.The mini axial pump weighing 27g (incl.5g rotor) has an outer diameter of 21mm and a length of 10mm in its largest point, but can produce a maximal blood flow of 6l/min with 50mmHg pressure increase. Therefore, it is suitable for the patients of 40-60kg body weight. For other patients of 60-80kg or 80-100kg body weight, the mini axial pumps of 23mm and 25mm outer diameter had been developed before, these devices were acknowledged to be the world smallest LVADs by Guinness World Record Center in 2004.The permanent maglev radial pump weighing 150g is a shaft-less centrifugal pump with permanent magnetic bearings developed by the author. It needs no second coil for suspension of the rotor except the motor coil, different from all other maglev pumps developed in USA, Japan, European, etc. Thus no detecting and controlling systems as well as no additional power supply for maglev are necessary. The pump can produce a blood flow up to as large as 10l/min against 100mmHg pressure.An implantable and durable blood pump will be a viable alternative to natural donor heart for transplantation.

System considerations favoring rotary artificial hearts with blood-immersed bearings.

PubMed

Jarvik, R K

1995-07-01

Hydrodynamic blood pumps provide such advantages as not requiring an air vent or compliance chamber as well as a great reduction in mechanical complexity with the potential for very long durability. The detailed design of their bearings is emerging as the single most important determinant of long-term success. Three categories of bearings include remote force, such as magnetic suspension; blood-isolated, which require a shaft seal; and blood-immersed using either mechanical or hydrodynamic support. Blood-immersed bearings permit maximum simplification and miniaturization of the entire system, require no flush fluid, and require no electronics as with magnetic suspension. The Jarvik 2000 heart represents an example of their potential. The intraventricular titanium pump (25 mm diameter, 25 cc, 85 g), uses blood flow through the motor air gap with blood-immersed bearings. The longest in vitro bearing durability test is ongoing at 20,000,000,000 revolutions with minimal wear (3 years at 15,000 rpm). In vivo results include 5-month calf survival, no thromboembolism, plasma Hb 2-5 mg%, and power under 10 W.

The flavonoid tangeretin inhibits invasion of MO4 mouse cells into embryonic chick heart in vitro.

PubMed

Bracke, M E; Vyncke, B M; Van Larebeke, N A; Bruyneel, E A; De Bruyne, G K; De Pestel, G H; De Coster, W J; Espeel, M F; Mareel, M M

1989-01-01

Tangeretin, a flavonoid from citrus plants, was found to inhibit the invasion of MO4 cells (Kirsten murine sarcoma virus transformed fetal mouse cells) into embryonic chick heart fragments in vitro. The flavonoid appeared to be chemically stable in tissue culture medium, and the anti-invasive effect was reversible on omission of the molecule from the medium. Unlike (+)-catechin, another anti-invasive flavonoid, tangeretin bound poorly to extracellular matrix. It did not alter fucosylated surface glycopeptides of MO4 cells. Tangeretin seemed not to act as a microtubule inhibitor, as immunocytochemistry revealed no disturbance of the cytoplasmic microtubule complex. However, at anti-invasive concentrations of tangeretin, cell proliferation and thymidine incorporation appeared to be inhibited. When cultured on an artificial substrate, treated MO4 cells were less elongated, covered a larger surface area and exhibited a slower directional migration than untreated cells. From the decrease in ATP content in MO4 cells after tangeretin treatment, we deduce that this flavonoid inhibits a number of intracellular processes, which leads to an inhibition of cell motility and hence of invasion.

[Study on application of SVM in prediction of coronary heart disease].

PubMed

Zhu, Yue; Wu, Jianghua; Fang, Ying

2013-12-01

Base on the data of blood pressure, plasma lipid, Glu and UA by physical test, Support Vector Machine (SVM) was applied to identify coronary heart disease (CHD) in patients and non-CHD individuals in south China population for guide of further prevention and treatment of the disease. Firstly, the SVM classifier was built using radial basis kernel function, liner kernel function and polynomial kernel function, respectively. Secondly, the SVM penalty factor C and kernel parameter sigma were optimized by particle swarm optimization (PSO) and then employed to diagnose and predict the CHD. By comparison with those from artificial neural network with the back propagation (BP) model, linear discriminant analysis, logistic regression method and non-optimized SVM, the overall results of our calculation demonstrated that the classification performance of optimized RBF-SVM model could be superior to other classifier algorithm with higher accuracy rate, sensitivity and specificity, which were 94.51%, 92.31% and 96.67%, respectively. So, it is well concluded that SVM could be used as a valid method for assisting diagnosis of CHD.

Generation of Murine Cardiac Pacemaker Cell Aggregates Based on ES-Cell-Programming in Combination with Myh6-Promoter-Selection

PubMed Central

Rimmbach, Christian; Jung, Julia J.; David, Robert

2015-01-01

Treatment of the “sick sinus syndrome” is based on artificial pacemakers. These bear hazards such as battery failure and infections. Moreover, they lack hormone responsiveness and the overall procedure is cost-intensive. “Biological pacemakers” generated from PSCs may become an alternative, yet the typical content of pacemaker cells in Embryoid Bodies (EBs) is extremely low. The described protocol combines “forward programming” of murine PSCs via the sinus node inducer TBX3 with Myh6-promoter based antibiotic selection. This yields cardiomyocyte aggregates consistent of >80% physiologically functional pacemaker cells. These “induced-sinoatrial-bodies” (“iSABs”) are spontaneously contracting at yet unreached frequencies (400-500 bpm) corresponding to nodal cells isolated from mouse hearts and are able to pace murine myocardium ex vivo. Using the described protocol highly pure sinus nodal single cells can be generated which e.g. can be used for in vitro drug testing. Furthermore, the iSABs generated according to this protocol may become a crucial step towards heart tissue engineering. PMID:25742394

Bleeding with the artificial heart: Gastrointestinal hemorrhage in CF-LVAD patients.

PubMed

Gurvits, Grigoriy E; Fradkov, Elena

2017-06-14

Continuous-flow left ventricular assist devices (CF-LVADs) have significantly improved outcomes for patients with end-stage heart failure when used as a bridge to cardiac transplantation or, more recently, as destination therapy. However, its implantations carries a risk of complications including infection, device malfunction, arrhythmias, right ventricular failure, thromboembolic disease, postoperative and nonsurgical bleeding. A significant number of left ventricular assist devices (LVAD) recipients may experience recurrent gastrointestinal hemorrhage, mainly due to combination of antiplatelet and vitamin K antagonist therapy, activation of fibrinolytic pathway, acquired von Willebrand factor deficiency, and tendency to develop small intestinal angiodysplasias due to increased rotary speed of the pump. Gastrointestinal bleeding in LVAD patients remains a source of increased morbidity including the need for blood transfusions, extended hospital stays, multiple readmissions, and overall mortality. Management of gastrointestinal bleeding in LVAD patients involves multidisciplinary approach in stabilizing the patients, addressing risk factors and performing structured endoluminal evaluation with focus on upper gastrointestinal tract including jejunum to find and eradicate culprit lesion. Medical and procedural intervention is largely successful and universal bleeding cessation occurs in transplanted patients.

A D-Shaped Bileaflet Bioprosthesis which Replicates Physiological Left Ventricular Flow Patterns

PubMed Central

Tan, Sean Guo-Dong; Kim, Sangho; Hon, Jimmy Kim Fatt; Leo, Hwa Liang

2016-01-01

Prior studies have shown that in a healthy heart, there exist a large asymmetric vortex structure that aids in establishing a steady flow field in the left ventricle. However, the implantation of existing artificial heart valves at the mitral position is found to have a negative effect on this physiological flow pattern. In light of this, a novel D-shaped bileaflet porcine bioprosthesis (GD valve) has been designed based on the native geometry mitral valve, with the hypothesis that biomimicry in valve design can restore physiological left ventricle flow patterns after valve implantation. An in-vitro experiment using two dimensional particle velocimetry imaging was carried out to determine the hemodynamic performance of the new bileaflet design and then compared to that of the well-established St. Jude Epic valve which functioned as a control in the experiment. Although both valves were found to have similar Reynolds shear stress and Turbulent Kinetic Energy levels, the novel D-shape valve was found to have lower turbulence intensity and greater mean kinetic energy conservation. PMID:27258099

[THEORETICAL BACKGROUND OF FINDING ORGANS FOR TRANSPLANTATION AMONG NON-HEART BEATING DONORS UNDER UNSUCCESSFUL EXTRACORPOREAL RESUSCITATION (LITERATURE REVIEW)].

PubMed

Khodeli, N; Chkhaidze, Z; Partsakhashvili, D; Pilishvili, O; Kordzaia, D

2016-05-01

The number of patients who are in the "Transplant Waiting List" is increasing each year. At the same time, as a result of the significant shortage of donor organs, part of the patients dies without waiting till surgery. According to the Maastricht classification for non-heart beating donors, the patients, who had cardiac arrest outside the hospital (in the uncontrolled by medical staff conditions) should be considered as a potential donors of category II. For these patients, the most effective resuscitation is recommended. The extracorporeal life support (ECLS) considers the connection to a special artificial perfusion system for the restoration of blood circulation out-of-hospital with further transportation to the hospital. If restoration of independent cardiac activity does not occur, in spite of the full range of resuscitative measures, these patients may be regarded as potential donors. The final decision should be received in the hospital, by the council of physicians, lawyers and patient's family members. Until the final decision, the prolongation of ECLS and maintaining adequate systemic and organic circulation is recommended.

Remote monitoring of left ventricular assist device parameters after HeartAssist-5 implantation.

PubMed

Pektok, Erman; Demirozu, Zumrut Tuba; Arat, Nurcan; Yildiz, Omer; Oklu, Emine; Eker, Deniz; Ece, Ferah; Ciftci, Cavlan; Yazicioglu, Nuran; Bayindir, Osman; Kucukaksu, Deniz Suha

2013-09-01

Although several left ventricular assist devices (LVADs) have been used widely, remote monitoring of LVAD parameters has been available only recently. We present our remote monitoring experience with an axial-flow LVAD (HeartAssist-5, MicroMed Cardiovascular, Inc., Houston, TX, USA). Five consecutive patients who were implanted a HeartAssist-5 LVAD because of end-stage heart failure due to ischemic (n=4) or idiopathic (n=1) cardiomyopathy, and discharged from hospital between December 2011 and January 2013 were analyzed. The data (pump speed, pump flow, power consumption) obtained from clinical visits and remote monitoring were studied. During a median follow-up of 253 (range: 80-394) days, fine tuning of LVADs was performed at clinical visits. All patients are doing well and are in New York Heart Association Class-I/II. A total of 39 alarms were received from three patients. One patient was hospitalized for suspected thrombosis and was subjected to physical examinations as well as laboratory and echocardiographic evaluations; however, no evidence of thrombus washout or pump thrombus was found. The patient was treated conservatively. Remaining alarms were due to insufficient water intake and were resolved by increased water consumption at night and summer times, and fine tuning of pump speed. No alarms were received from the remaining two patients. We believe that remote monitoring is a useful technology for early detection and treatment of serious problems occurring out of hospital thereby improving patient care. Future developments may ease troubleshooting, provide more data from the patient and the pump, and eventually increase physician and patient satisfaction. Despite all potential clinical benefits, remote monitoring should be taken as a supplement to rather than a substitute for routine clinical visits for patient follow-up. © 2013 Wiley Periodicals, Inc. and International Center for Artificial Organs and Transplantation.

Development of a pump flow estimator for rotary blood pumps to enhance monitoring of ventricular function.

PubMed

Granegger, Marcus; Moscato, Francesco; Casas, Fernando; Wieselthaler, Georg; Schima, Heinrich

2012-08-01

Estimation of instantaneous flow in rotary blood pumps (RBPs) is important for monitoring the interaction between heart and pump and eventually the ventricular function. Our group has reported an algorithm to derive ventricular contractility based on the maximum time derivative (dQ/dt(max) as a substitute for ventricular dP/dt(max) ) and pulsatility of measured flow signals. However, in RBPs used clinically, flow is estimated with a bandwidth too low to determine dQ/dt(max) in the case of improving heart function. The aim of this study was to develop a flow estimator for a centrifugal pump with bandwidth sufficient to provide noninvasive cardiac diagnostics. The new estimator is based on both static and dynamic properties of the brushless DC motor. An in vitro setup was employed to identify the performance of pump and motor up to 20 Hz. The algorithm was validated using physiological ventricular and arterial pressure waveforms in a mock loop which simulated different contractilities (dP/dt(max) 600 to 2300 mm Hg/s), pump speeds (2 to 4 krpm), and fluid viscosities (2 to 4 mPa·s). The mathematically estimated pump flow data were then compared to the datasets measured in the mock loop for different variable combinations (flow ranging from 2.5 to 7 L/min, pulsatility from 3.5 to 6 L/min, dQ/dt(max) from 15 to 60 L/min/s). Transfer function analysis showed that the developed algorithm could estimate the flow waveform with a bandwidth up to 15 Hz (±2 dB). The mean difference between the estimated and measured average flows was +0.06 ± 0.31 L/min and for the flow pulsatilities -0.27 ± 0.2 L/min. Detection of dQ/dt(max) was possible up to a dP/dt(max) level of 2300 mm Hg/s. In conclusion, a flow estimator with sufficient frequency bandwidth and accuracy to allow determination of changes in ventricular contractility even in the case of improving heart function was developed. © 2012, Copyright the Authors. Artificial Organs © 2012, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Physiological and behavioral stress parameters in calves in response to partial scrotal resection, orchidectomy, and Burdizzo castration.

PubMed

Pieler, D; Peinhopf, W; Becher, A C; Aurich, J E; Rose-Meierhöfer, S; Erber, R; Möstl, E; Aurich, C

2013-10-01

Establishing artificial cryptorchids by partial scrotal resection without removing the testicles is a technique for castration of bull calves that recently has gained new interest. In contrast to orchidectomy and Burdizzo castration, the stress response of calves to shortening of the scrotum is unknown. In this study, partial scrotal resection in bull calves was compared with orchidectomy, Burdizzo castration, and controls without intervention (n=10 per group, ages 56 ± 3 d). Procedures were performed under xylazine sedation and local anesthesia. We hypothesized that partial scrotal resection is least stressful. Salivary cortisol, heart rate, heart rate variability, behavior, and locomotion were analyzed. Cortisol concentration peaked 60 min after start of the procedures. Cortisol release was at least in part xylazine induced and none of the experimental procedures released additional cortisol. Heart rate increased in calves of all groups with initial handling, but immediately after xylazine sedation decreased to 30% below initial values and was not modified by surgical procedures. The heart rate variability variables standard deviation of beat-to-beat interval and root mean square of successive beat-to-beat differences increased when calves were placed on the surgery table but effects were similar in calves submitted to surgeries and control calves. Locomotion increased, whereas lying time decreased in response to all surgeries. Locomotion increase was most pronounced after orchidectomy. Plasma fibrinogen concentrations increased after orchidectomy only. With adequate pain medication, orchidectomy, Burdizzo castration, and partial scrotal resection do not differ with regard to acute stress and, by inference, pain. Partial scrotal resection when carried out under xylazine sedation and local anesthesia thus is an acceptable castration technique in bull calves. Copyright © 2013 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Effect of erythrocyte aggregation on optical transmission of blood

NASA Astrophysics Data System (ADS)

Shvartsman, L. D.; Fine, I.

2007-02-01

We present here a bird-eye view of time-dependent optical transmission of blood in red-near infrared spectral range. This issue is of the key importance both for fundamental understanding and for various applications connected with non-invasive optical blood analysis. A number of experiments measuring kinetics of blood transmission in the case of natural heart pulsations and of artificial kinetics following over-systolic occlusion is reviewed. The comprehensive theoretical approach has to consider scattering-associated mechanism rather than the widely accepted absorption-associated one. Light scattering occurs on RBC aggregates. The size of aggregates and their shape change in time due to blood flow variations. It results in the corresponding changes of optical transmission.

Electricity unplugged

NASA Astrophysics Data System (ADS)

Karalis, Aristeidis

2009-02-01

The judge was driving back late one cold winter night. Entering the garage, the battery-charging indicator in his wirelessly powered electric car came on. "Home at last," crossed his mind. He swiped his personal smartcard on the front-door detector to be let in. He heard a "charging" beep from his mobile phone. The blinking cursor on the half-finished e-mail on the laptop had been waiting all day on the side table. He picked the computer up and walked towards his desk. "Good evening, your honour. Your wirelessly heated robe," said the butler-robot as it approached from the kitchen. Putting on the electric garment, he sat on the medical desk chair. His artificial heart was now beating faster.

Incompressible viscous flow computations for the pump components and the artificial heart

NASA Technical Reports Server (NTRS)

Kiris, Cetin

1992-01-01

A finite difference, three dimensional incompressible Navier-Stokes formulation to calculate the flow through turbopump components is utilized. The solution method is based on the pseudo compressibility approach and uses an implicit upwind differencing scheme together with the Gauss-Seidel line relaxation method. Both steady and unsteady flow calculations can be performed using the current algorithm. Here, equations are solved in steadily rotating reference frames by using the steady state formulation in order to simulate the flow through a turbopump inducer. Eddy viscosity is computed by using an algebraic mixing-length turbulence model. Numerical results are compared with experimental measurements and a good agreement is found between the two.

Tachycardia-bradycardia syndrome: Electrophysiological mechanisms and future therapeutic approaches (Review)

PubMed Central

Tse, Gary; Liu, Tong; Li, Ka Hou Christien; Laxton, Victoria; Wong, Andy On-Tik; Chan, Yin Wah Fiona; Keung, Wendy; Chan, Camie W.Y.; Li, Ronald A.

2017-01-01

Sick sinus syndrome (SSS) encompasses a group of disorders whereby the heart is unable to perform its pacemaker function, due to genetic and acquired causes. Tachycardia-bradycardia syndrome (TBS) is a complication of SSS characterized by alternating tachycardia and bradycardia. Techniques such as genetic screening and molecular diagnostics together with the use of pre-clinical models have elucidated the electrophysiological mechanisms of this condition. Dysfunction of ion channels responsible for initiation or conduction of cardiac action potentials may underlie both bradycardia and tachycardia; bradycardia can also increase the risk of tachycardia, and vice versa. The mainstay treatment option for SSS is pacemaker implantation, an effective approach, but has disadvantages such as infection, limited battery life, dislodgement of leads and catheters to be permanently implanted in situ. Alternatives to electronic pacemakers are gene-based bio-artificial sinoatrial node and cell-based bio-artificial pacemakers, which are promising techniques whose long-term safety and efficacy need to be established. The aim of this article is to review the different ion channels involved in TBS, examine the three-way relationship between ion channel dysfunction, tachycardia and bradycardia in TBS and to consider its current and future therapies. PMID:28204831

Tachycardia-bradycardia syndrome: Electrophysiological mechanisms and future therapeutic approaches (Review).

PubMed

Tse, Gary; Liu, Tong; Li, Ka Hou Christien; Laxton, Victoria; Wong, Andy On-Tik; Chan, Yin Wah Fiona; Keung, Wendy; Chan, Camie W Y; Li, Ronald A

2017-03-01

Sick sinus syndrome (SSS) encompasses a group of disorders whereby the heart is unable to perform its pacemaker function, due to genetic and acquired causes. Tachycardia‑bradycardia syndrome (TBS) is a complication of SSS characterized by alternating tachycardia and bradycardia. Techniques such as genetic screening and molecular diagnostics together with the use of pre-clinical models have elucidated the electrophysiological mechanisms of this condition. Dysfunction of ion channels responsible for initiation or conduction of cardiac action potentials may underlie both bradycardia and tachycardia; bradycardia can also increase the risk of tachycardia, and vice versa. The mainstay treatment option for SSS is pacemaker implantation, an effective approach, but has disadvantages such as infection, limited battery life, dislodgement of leads and catheters to be permanently implanted in situ. Alternatives to electronic pacemakers are gene‑based bio‑artificial sinoatrial node and cell‑based bio‑artificial pacemakers, which are promising techniques whose long-term safety and efficacy need to be established. The aim of this article is to review the different ion channels involved in TBS, examine the three‑way relationship between ion channel dysfunction, tachycardia and bradycardia in TBS and to consider its current and future therapies.

Classification of a Driver's cognitive workload levels using artificial neural network on ECG signals.

PubMed

Tjolleng, Amir; Jung, Kihyo; Hong, Wongi; Lee, Wonsup; Lee, Baekhee; You, Heecheon; Son, Joonwoo; Park, Seikwon

2017-03-01

An artificial neural network (ANN) model was developed in the present study to classify the level of a driver's cognitive workload based on electrocardiography (ECG). ECG signals were measured on 15 male participants while they performed a simulated driving task as a primary task with/without an N-back task as a secondary task. Three time-domain ECG measures (mean inter-beat interval (IBI), standard deviation of IBIs, and root mean squared difference of adjacent IBIs) and three frequencydomain ECG measures (power in low frequency, power in high frequency, and ratio of power in low and high frequencies) were calculated. To compensate for individual differences in heart response during the driving tasks, a three-step data processing procedure was performed to ECG signals of each participant: (1) selection of two most sensitive ECG measures, (2) definition of three (low, medium, and high) cognitive workload levels, and (3) normalization of the selected ECG measures. An ANN model was constructed using a feed-forward network and scaled conjugate gradient as a back-propagation learning rule. The accuracy of the ANN classification model was found satisfactory for learning data (95%) and testing data (82%). Copyright © 2016 Elsevier Ltd. All rights reserved.

[Role of rostral ventrolateral medulla in the pressor response to intraventricular (4th) injection of substance P].

PubMed

Zhang, X H; Ni, H

1998-04-01

Experiments were done in rabbits anaesthetized with urethane and immobilized under artificial respiration. It was found that substance P (SP, 0.8 ng/kg dissolved in 100 microliters artificial cerebro-spinal fluid, CSF) injected into the 4th ventricle induced either a rise or a drop of pulmonary arterial pressure (PAP) with predominated pressor response. In addition, a rise in carotid arterial pressure (CAP) and reduction in heart rate (HR) were also observed, whereas no significant alteration in PAP, CAP and HR was observed. Microinjection of SP receptor antagonist [D-Pro2, D-Phe7, D-Trp9]--SP (5-10 ng dissolved in 0.5 microliter CSF) or phentolamine (2-3 micrograms dissolved in 0.5 microliter CSF) into the bilateral rostral ventrolateral medulla (rVLM) prior to intraventricular injection of SP could block the SP-induced pressor responses in pulmonary and carotid arteries, while microinjection of SP receptor antagonist or phentolamine into bilateral caudal ventrolateral medulla (cVLM) at the same dosage had no effect. The results show that SP-induced pulmonary and carotid pressor responses may be mediated through SP-receptor and alpha-adrenergic receptors in the rostral ventro-lateral medulla (rVLM).

The Gravbed - artificial gravity for long-term missions

NASA Astrophysics Data System (ADS)

Duenckelmeyer, M.; Ullmann, F.; Gierer, T.; Keller, R.

With this experiment we have applied for the Student Parabolic Flight Campaign of the Esa The effects of long-term missions under micro-gravity conditions on the human body are quite enormous Some of these effects can lead to severe medical problems such as osteoporosis Spider Legs and Puffy Face functional circulatory disorders Space Adaptation Syndrome and a decreasing of the baro-reflex Thus a number of different countermeasures are required to combat these negative effects This proposed experiment will counter some of these effects by applying artificial gravity to the body of an individual crewmember during the sleeping period Using the wasted time of sleep for this important countermeasure is the innovation of this project The proposed method aims at countering negative effects of micro-gravity on the cardio-vasculaer system heart blood circuit and intestinal organs Other effects such as bone or muscle degeneration cannot be counter to a use extent The artificial gravity used in this experiment will be created by rotation around one stable axis As the rotation radius will be quite small the rotational speed will have to be quite high in order to achieve a gravitational load of one G Under these conditions the effects of the coriolis force on the human body seem to be a defining factor possibly even a show stopper Looking at the coriolis force more closely it can be seen that it only applies for test persons moving in a rotating environment Thus we propose to fix the test person in such a way that on the one hand

Use of Wearable Sensors and Biometric Variables in an Artificial Pancreas System.

PubMed

Turksoy, Kamuran; Monforti, Colleen; Park, Minsun; Griffith, Garett; Quinn, Laurie; Cinar, Ali

2017-03-07

An artificial pancreas (AP) computes the optimal insulin dose to be infused through an insulin pump in people with Type 1 Diabetes (T1D) based on information received from a continuous glucose monitoring (CGM) sensor. It has been recognized that exercise is a major challenge in the development of an AP system. The use of biometric physiological variables in an AP system may be beneficial for prevention of exercise-induced challenges and better glucose regulation. The goal of the present study is to find a correlation between biometric variables such as heart rate (HR), heat flux (HF), skin temperature (ST), near-body temperature (NBT), galvanic skin response (GSR), and energy expenditure (EE), 2D acceleration-mean of absolute difference (MAD) and changes in glucose concentrations during exercise via partial least squares (PLS) regression and variable importance in projection (VIP) in order to determine which variables would be most useful to include in a future artificial pancreas. PLS and VIP analyses were performed on data sets that included seven different types of exercises. Data were collected from 26 clinical experiments. Clinical results indicate ST to be the most consistently important (important for six out of seven tested exercises) variable over all different exercises tested. EE and HR are also found to be important variables over several types of exercise. We also found that the importance of GSR and NBT observed in our experiments might be related to stress and the effect of changes in environmental temperature on glucose concentrations. The use of the biometric measurements in an AP system may provide better control of glucose concentration.

Listening to Relaxing Music Improves Physiological Responses in Premature Infants: A Randomized Controlled Trial.

PubMed

Caparros-Gonzalez, Rafael A; de la Torre-Luque, Alejandro; Diaz-Piedra, Carolina; Vico, Francisco J; Buela-Casal, Gualberto

2018-02-01

Premature infants are exposed to high levels of noise in the neonatal intensive care unit (NICU). This study evaluated the effect of a relaxing music therapy intervention composed by artificial intelligence on respiratory rate, systolic and diastolic blood pressure, and heart rate. A double-blind, randomized, controlled trial was conducted in the NICUs of 2 general public hospitals in Andalusia, Spain. Participants were 17 healthy premature infants, randomly allocated to the intervention group or the control group (silence) at a 1:1 ratio. To be included in the study, the subjects were to be 32 to 36 weeks of gestation at birth (M= 32.33; SD = 1.79) and passed a hearing screening test satisfactorily. The intervention lasted 20 minutes, 3 times a day for 3 consecutive days, while infants were in the incubator. Infants' heart rate, respiratory rate, and blood pressure were assessed before and after each intervention session. After each session, the respiratory rate decreased in the experimental group (main between-groups effect (F1,13 = 6.73, P = .022, ηpartial = 0.34). Across the sessions, the heart rate increased in the control group (main between-groups effect, F1,11 = 5.09, P = .045, ηpartial = 0.32). Future studies can use this music intervention to assess its potential effects in premature infants. Nurses can apply the relaxing music intervention presented in this study to ameliorate the impact of the stressful environment on premature infants.

Chronic repeated exposure to weather-related stimuli elicits few symptoms of chronic stress in captive molting and non-molting European starlings (Sturnus vulgaris).

PubMed

de Bruijn, Robert; Reed, J Michael; Romero, L Michael

2017-10-01

Repeated exposure to acute stressors causes dramatic changes in an animal's stress physiology and the cumulative effects are often called chronic stress. Recently we showed that short-term exposure to weather-related stimuli, such as temperature change, artificial precipitation, and food restriction, cause acute responses in captive European starlings (Sturnus vulgaris). Here, we examined the effect of repeated exposure to weather-related stressors on heart rate and corticosterone (CORT) of captive non-molting and molting European starlings. Four times every day for 3 weeks, birds were exposed to either 30 min of a subtle (3°C) decrease in temperature, a short bout of simulated rain, or 2 hr of food removal. The order and time of presentation were randomly assigned on each day. We found no differences in heart rate or heart rate variability. Furthermore, there were no changes in baseline CORT levels, CORT negative feedback efficacy, or maximal adrenal capacity. Mass increased across the experimental period only in molting birds. CORT responses to restraint were decreased in both groups following treatment, suggesting the birds had downregulated their responses to acute stress. Molting birds showed evidence of suppression of the HPA axis compared with non-molting birds, which is consistent with previous research. Overall, our data show that repeated exposure to weather-related stressors does not elicit most of the symptoms normally associated with chronic stress. © 2018 Wiley Periodicals, Inc.

A Mini Axial and a Permanent Maglev Radial Heart Pump§

PubMed Central

Qian, Kun-Xi; Ru, Wei-Min; Wang, Hao; Jing, Teng

2007-01-01

The implantability and durability have been for decades the focus of artificial heart R&D. A mini axial and a maglev radial pump have been developed to meet with such requirements. The mini axial pump weighing 27g (incl.5g rotor) has an outer diameter of 21mm and a length of 10mm in its largest point, but can produce a maximal blood flow of 6l/min with 50mmHg pressure increase. Therefore, it is suitable for the patients of 40-60kg body weight. For other patients of 60-80kg or 80-100kg body weight, the mini axial pumps of 23mm and 25mm outer diameter had been developed before, these devices were acknowledged to be the world smallest LVADs by Guinness World Record Center in 2004. The permanent maglev radial pump weighing 150g is a shaft-less centrifugal pump with permanent magnetic bearings developed by the author. It needs no second coil for suspension of the rotor except the motor coil, different from all other maglev pumps developed in USA, Japan, European, etc. Thus no detecting and controlling systems as well as no additional power supply for maglev are necessary. The pump can produce a blood flow up to as large as 10l/min against 100mmHg pressure. An implantable and durable blood pump will be a viable alternative to natural donor heart for transplantation. PMID:19662120

Evaluation of Death among the Patients Undergoing Permanent Pacemaker Implantation: A Competing Risks Analysis.

PubMed

Ghaem, Haleh; Ghorbani, Mohammad; Zare Dorniani, Samira

2017-06-01

Permanent artificial pacemaker is one of the important therapies for treatment of cardiac conduction system problems. The present study aimed to determine the association between some predictive variables and all-cause and cause-specific mortality in the patients who had undergone pacemaker implantation. This study was conducted on 1207 patients who had undergone permanent pacemaker implantation in the hospitals affiliated with Shiraz University of Medical Sciences, Iran, from Mar 2002 to Mar 2012. The variables that existed in the patients' medical records included sex, diabetes mellitus, obesity, cerebrovascular accident, cardiomegaly, smoking, hypertension, ischemic heart disease, congenital heart disease, sick sinus syndrome, and atrial fibrillation. Competing risks model was used to assess the association between the predictive variables and cause-specific (i.e., cardiac and vascular) mortality. The patients' mean age was 66.32±17.92 yr (70.62±14.45 yr in the patients with single-chamber pacemakers vs. 61.91±17.69 yr in those with two-chamber pacemakers) ( P <0.001). Sick sinus syndrome and age increased the risk of all-cause mortality, while two-chamber pacemaker decreased this risk. Obesity increased the risk of cardiac death, and diabetes mellitus and heart valve disease increased the risk of vascular death. The variables predicting mortality in all-cause model were completely different from those in cause-specific model. Moreover, death in such patients may occur due to reasons other than pacemaker. Therefore, future studies, particularly prospective ones, are recommended to use competing risks models.

Automatic assessment of mitral regurgitation severity based on extensive textural features on 2D echocardiography videos.

PubMed

Moghaddasi, Hanie; Nourian, Saeed

2016-06-01

Heart disease is the major cause of death as well as a leading cause of disability in the developed countries. Mitral Regurgitation (MR) is a common heart disease which does not cause symptoms until its end stage. Therefore, early diagnosis of the disease is of crucial importance in the treatment process. Echocardiography is a common method of diagnosis in the severity of MR. Hence, a method which is based on echocardiography videos, image processing techniques and artificial intelligence could be helpful for clinicians, especially in borderline cases. In this paper, we introduce novel features to detect micro-patterns of echocardiography images in order to determine the severity of MR. Extensive Local Binary Pattern (ELBP) and Extensive Volume Local Binary Pattern (EVLBP) are presented as image descriptors which include details from different viewpoints of the heart in feature vectors. Support Vector Machine (SVM), Linear Discriminant Analysis (LDA) and Template Matching techniques are used as classifiers to determine the severity of MR based on textural descriptors. The SVM classifier with Extensive Uniform Local Binary Pattern (ELBPU) and Extensive Volume Local Binary Pattern (EVLBP) have the best accuracy with 99.52%, 99.38%, 99.31% and 99.59%, respectively, for the detection of Normal, Mild MR, Moderate MR and Severe MR subjects among echocardiography videos. The proposed method achieves 99.38% sensitivity and 99.63% specificity for the detection of the severity of MR and normal subjects. Copyright © 2016 Elsevier Ltd. All rights reserved.

Interactive simulator for e-Learning environments: a teaching software for health care professionals.

PubMed

De Lazzari, Claudio; Genuini, Igino; Pisanelli, Domenico M; D'Ambrosi, Alessandra; Fedele, Francesco

2014-12-18

There is an established tradition of cardiovascular simulation tools, but the application of this kind of technology in the e-Learning arena is a novel approach. This paper presents an e-Learning environment aimed at teaching the interaction of cardiovascular and lung systems to health-care professionals. Heart-lung interaction must be analyzed while assisting patients with severe respiratory problems or with heart failure in intensive care unit. Such patients can be assisted by mechanical ventilatory assistance or by thoracic artificial lung."In silico" cardiovascular simulator was experimented during a training course given to graduate students of the School of Specialization in Cardiology at 'Sapienza' University in Rome.The training course employed CARDIOSIM©: a numerical simulator of the cardiovascular system. Such simulator is able to reproduce pathophysiological conditions of patients affected by cardiovascular and/or lung disease. In order to study the interactions among the cardiovascular system, the natural lung and the thoracic artificial lung (TAL), the numerical model of this device has been implemented. After having reproduced a patient's pathological condition, TAL model was applied in parallel and hybrid model during the training course.Results obtained during the training course show that TAL parallel assistance reduces right ventricular end systolic (diastolic) volume, but increases left ventricular end systolic (diastolic) volume. The percentage changes induced by hybrid TAL assistance on haemodynamic variables are lower than those produced by parallel assistance. Only in the case of the mean pulmonary arterial pressure, there is a percentage reduction which, in case of hybrid assistance, is greater (about 40%) than in case of parallel assistance (20-30%).At the end of the course, a short questionnaire was submitted to students in order to assess the quality of the course. The feedback obtained was positive, showing good results with respect to the degree of students' learning and the ease of use of the software simulator.

Implantable control, telemetry, and solar energy system in the moving actuator type total artificial heart.

PubMed

Ahn, J M; Lee, J H; Choi, S W; Kim, W E; Omn, K S; Park, S K; Kim, W G; Roh, J R; Min, B G

1998-03-01

The moving actuator type total artificial heart (TAH) developed in the Seoul National University has numerous design improvements based upon the digital signal processor (DSP). These improvements include the implantability of all electronics, an automatic control algorithm, and extension of the battery run-time in connection with an amorphous silicon solar system (SS). The implantable electronics consist of the motor drive, main processor, intelligent Li ion battery management (LIBM) based upon the DSP, telemetry system, and transcutaneous energy transmission (TET) system. Major changes in the implantable electronics include decreasing the temperature rise by over 21 degrees C on the motor drive, volume reduction (40 x 55 x 33 mm, 7 cell assembly) of the battery pack using a Li ion (3.6 V/cell, 900 mA.h), and improvement of the battery run-time (over 40 min) while providing the cardiac output (CO) of 5 L/min at 100 mm Hg afterload when the external battery for testing is connected with the SS (2.5 W, 192.192, 1 kg) for the external battery recharge or the partial TAH drive. The phase locked loop (PLL) based telemetry system was implemented to improve stability and the error correction DSP algorithm programmed to achieve high accuracy. A field focused light emitting diode (LED) was used to obtain low light scattering along the propagation path, similar to the optical property of the laser and miniature sized, mounted on the pancake type TET coils. The TET operating resonance frequency was self tuned in a range of 360 to 410 kHz to provide enough power even at high afterloads. An automatic cardiac output regulation algorithm was developed based on interventricular pressure analysis and carried out in several animal experiments successfully. All electronics have been evaluated in vitro and in vivo and prepared for implantation of the TAH. Substantial progress has been made in designing a completely implantable TAH at the preclinical stage.

Ultracompact, completely implantable permanent use electromechanical ventricular assist device and total artificial heart.

PubMed

Honda, N; Inamoto, T; Nogawa, M; Takatani, S

1999-03-01

An ultracompact, completely implantable permanent use electromechanical ventricular assist device (VAD) and total artificial heart (TAH) intended for 50-60 kg size patients have been developed. The TAH and VAD share a miniature electromechanical actuator that comprises a DC brushless motor and a planetary roller screw. The rotational force of the motor is converted into the rectilinear force of the roller screw to actuate the blood pump. The TAH is a one piece design with left and right pusher plate type blood pumps sandwiching an electromechanical actuator. The VAD is one half of the TAH with the same actuator but a different pump housing and a backplate. The blood contacting surfaces, including those of the flexing diaphragm and pump housing, of both the VAD and TAH were made of biocompatible polyurethane. The diameter, thickness, volume, and weight of the VAD are 90 mm, 56 mm, 285 cc, and 380 g, respectively, while those of the TAH are 90 mm, 73 mm, 400 cc, and 440 g, respectively. The design stroke volume of both the VAD and TAH is 60 cc with the stroke length being 12 mm. The stroke length and motor speed are controlled solely based on the commutation signals of the motor. An in vitro study revealed that a maximum pump flow of 7.5 L/min can be obtained with a pump rate of 140 bpm against a mean afterload of 100 mm Hg. The power requirement ranged from 4 to 6 W to deliver a 4-5 L/min flow against a 100 mm Hg afterload with the electrical-to-hydraulic efficiency being 19-20%. Our VAD and TAH are the smallest of the currently available devices and suitable for bridge to transplant application as well as for permanent circulatory support of 50-60 kg size patients.

First report of 90-day support of 2 calves with a continuous-flow total artificial heart.

PubMed

Karimov, Jamshid H; Moazami, Nader; Kobayashi, Mariko; Sale, Shiva; Such, Kimberly; Byram, Nicole; Sunagawa, Gengo; Horvath, David; Gao, Shengqiang; Kuban, Barry; Golding, Leonard A R; Fukamachi, Kiyotaka

2015-09-01

The Cleveland Clinic continuous-flow total artificial heart (CFTAH) is a compact, single-piece, valveless, pulsatile pump providing self-regulated hemodynamic output to left/right circulation. We evaluated chronic in vivo pump performance, physiologic and hemodynamic parameters, and biocompatibility of the CFTAH in a well-established calf model. CFTAH pumps have been implanted in 17 calves total. Hemodynamic parameters, pump performance, and device-related adverse events were evaluated during studies and at necropsy. In vivo experiments demonstrated good hemodynamic performance (pump flow, 7.3 ± 0.7 L/min; left atrial pressure, 16 ± 3 mm Hg; right atrial pressure, 17 ± 3 mm Hg; right atrial pressure-left atrial pressure difference, 1 ± 2 mm Hg; mean arterial pressure, 103 ± 7 mm Hg; arterial pulse pressure, 30 ± 11 mm Hg; and pulmonary arterial pressure, 34 ± 5 mm Hg). The CFTAH has operated within design specifications and never failed. With ever-improving pump design, the implants have shown no chronic hemolysis. Three animals with recent CFTAH implantation recovered well, with no postoperative anticoagulation, during planned in vivo durations of 30, 90, and 90 days (last 2 were intended to be 90-day studies). All these longest-surviving cases showed good biocompatibility, with no thromboembolism in organs. The current CFTAH has demonstrated reliable self-regulation of hemodynamic output and acceptable biocompatibility without anticoagulation throughout 90 days of chronic implantation in calves. Meeting these milestones is in accord with our strategy to achieve transfer of this unique technology to human surgical practice, thus filling the urgent need for cardiac replacement devices as destination therapy. Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Animal studies with the Carmat bioprosthetic total artificial heart.

PubMed

Latrémouille, Christian; Duveau, Daniel; Cholley, Bernard; Zilberstein, Luca; Belbis, Guillaume; Boughenou, Marie-Fazia; Meleard, Denis; Bruneval, Patrick; Adam, Clovis; Neuschwander, Arthur; Perles, Jean-Christophe; Jansen, Piet; Carpentier, Alain

2015-05-01

The Carmat bioprosthetic total artificial heart (TAH) contains bioprosthetic blood-contacting surfaces, and is designed for orthotopic cardiac replacement. In preparation for clinical studies, we evaluated the TAH performance and its effects on end-organ function in an animal model. Twelve female Charolais calves, 2-3 months of age and weighing 102-122 kg, were implanted with the TAH through a mid-sternotomy to ensure an adequate anatomic fit. The intended support duration was 4-10 days. Haematological values, creatinine, bilirubin and lactate levels were measured and mean arterial and central venous pressure, central venous oxygen saturation and TAH parameters were monitored. The calves were placed in a cage immediately postoperatively, and extubated on postoperative day 1 in most cases. Average support duration was 3 days, with 4 of 12 calves supported for 4, 4, 8 and 10 days. The initial procedures were used to refine surgical techniques and postoperative care. Pump output ranged from 7.3 to 10 l/min. Haemodynamic parameters and blood analysis were within acceptable ranges. No device failures occurred. No anticoagulation was used in the postoperative phase. The calves were euthanized in case of discomfort compromising the animal well-being, such as respiratory dysfunction, severe blood loss and cerebral dysfunction. Device explant analysis showed no thrombus formation inside the blood cavities. Histological examination of kidneys showed isolated micro-infarction in 2/12 animals; brain histology revealed no thromboembolic depositions. The Carmat bioprosthetic TAH implanted in calves up to 10 days provided adequate blood flow to organs and tissues. Low levels of haemolysis and no visible evidence of thromboembolic depositions in major organs and device cavities, without the use of anticoagulation, may indicate early-phase haemocompatibility of the TAH. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Stem Cell-Derived Exosome in Cardiovascular Diseases: Macro Roles of Micro Particles.

PubMed

Yuan, Ye; Du, Weijie; Liu, Jiaqi; Ma, Wenya; Zhang, Lai; Du, Zhimin; Cai, Benzhi

2018-01-01

The stem cell-based therapy has emerged as the promising therapeutic strategies for cardiovascular diseases (CVDs). Recently, increasing evidence suggest stem cell-derived active exosomes are important communicators among cells in the heart via delivering specific substances to the adjacent/distant target cells. These exosomes and their contents such as certain proteins, miRNAs and lncRNAs exhibit huge beneficial effects on preventing heart damage and promoting cardiac repair. More importantly, stem cell-derived exosomes are more effective and safer than stem cell transplantation. Therefore, administration of stem cell-derived exosomes will expectantly be an alternative stem cell-based therapy for the treatment of CVDs. Furthermore, modification of stem cell-derived exosomes or artificial synthesis of exosomes will be the new therapeutic tools for CVDs in the future. In addition, stem cell-derived exosomes also have been implicated in the diagnosis and prognosis of CVDs. In this review, we summarize the current advances of stem cell-derived exosome-based treatment and prognosis for CVDs, including their potential benefits, underlying mechanisms and limitations, which will provide novel insights of exosomes as a new tool in clinical therapeutic translation in the future.

Temporal abstraction and inductive logic programming for arrhythmia recognition from electrocardiograms.

PubMed

Carrault, G; Cordier, M-O; Quiniou, R; Wang, F

2003-07-01

This paper proposes a novel approach to cardiac arrhythmia recognition from electrocardiograms (ECGs). ECGs record the electrical activity of the heart and are used to diagnose many heart disorders. The numerical ECG is first temporally abstracted into series of time-stamped events. Temporal abstraction makes use of artificial neural networks to extract interesting waves and their features from the input signals. A temporal reasoner called a chronicle recogniser processes such series in order to discover temporal patterns called chronicles which can be related to cardiac arrhythmias. Generally, it is difficult to elicit an accurate set of chronicles from a doctor. Thus, we propose to learn automatically from symbolic ECG examples the chronicles discriminating the arrhythmias belonging to some specific subset. Since temporal relationships are of major importance, inductive logic programming (ILP) is the tool of choice as it enables first-order relational learning. The approach has been evaluated on real ECGs taken from the MIT-BIH database. The performance of the different modules as well as the efficiency of the whole system is presented. The results are rather good and demonstrate that integrating numerical techniques for low level perception and symbolic techniques for high level classification is very valuable.

Effect of a 1800 MHz electromagnetic field emitted during embryogenesis on chick development and hatchability.

PubMed

Pawlak, K; Nieckarz, Z; Sechman, A; Wojtysiak, D; Bojarski, B; Tombarkiewicz, B

2018-06-01

The level of artificial electromagnetic field (EMF) has steadily increased with the development of human civilization. The developing chicken embryo has been considered a good model to study the effects of EMF on living organisms. The aim of the study was to determine the effect of a 1800 MHz electromagnetic field during embryogenesis on the frequency of chick embryo malformations, morphometric parameters of the heart and liver and concentration of corticosterone in blood plasma, lipid and glycogen content in the liver of newly hatched chicks. A 1800 MHz EMF was found to shorten the duration of embryogenesis (earlier pipping and hatching of chicks) while having no effect on the quantity and quality of chicks and on increasing the incidence of embryo malformations. Exposure of chick embryos to EMF caused decreases in relative heart weight and right ventricle wall thickness. The pipping and hatching of chicks can be accelerated by stressful impact of EMF, which is confirmed by a significant increase in plasma corticosterone concentrations and decrease in fat and glycogen in the liver of chicks exposed during embryogenesis on the electromagnetic field with a frequency of 1800 MHz. © 2018 Blackwell Verlag GmbH.

Impact of the material composition on proton range variation - A Monte Carlo study

NASA Astrophysics Data System (ADS)

Wu, S. W.; Tung, C. J.; Lee, C. C.; Fan, K. H.; Huang, H. C.; Chao, T. C.

2015-11-01

In this study, we used the Geant4 toolkit to demonstrate the impacts of the material composition of tissues on proton range variation. Bragg curves of different materials subjected to a 250 MeV mono-energy proton beam were simulated and compared. These simulated materials included adipose, heart, brain, cartilage, cortical bone and water. The results showed that there was significant proton range deviation between Bragg curves, especially for cortical bone. The R50 values for a 250 MeV proton beam were approximately 39.55 cm, 35.52 cm, 37.00 cm, 36.51 cm, 36.72 cm, 22.53 cm, and 38.52 cm in the phantoms that were composed completely of adipose, cartilage, tissue, heart, brain, cortical bone, and water, respectively. Mass density and electron density were used to scale the proton range for each material; electron density provided better range scaling. In addition, a similar comparison was performed by artificially setting all material density to 1.0 g/cm3 to evaluate the range deviation due to chemical components alone. Tissue heterogeneity effects due to density variation were more significant, and less significant for chemical composition variation unless the Z/A was very different.

A machine learning system to improve heart failure patient assistance.

PubMed

Guidi, Gabriele; Pettenati, Maria Chiara; Melillo, Paolo; Iadanza, Ernesto

2014-11-01

In this paper, we present a clinical decision support system (CDSS) for the analysis of heart failure (HF) patients, providing various outputs such as an HF severity evaluation, HF-type prediction, as well as a management interface that compares the different patients' follow-ups. The whole system is composed of a part of intelligent core and of an HF special-purpose management tool also providing the function to act as interface for the artificial intelligence training and use. To implement the smart intelligent functions, we adopted a machine learning approach. In this paper, we compare the performance of a neural network (NN), a support vector machine, a system with fuzzy rules genetically produced, and a classification and regression tree and its direct evolution, which is the random forest, in analyzing our database. Best performances in both HF severity evaluation and HF-type prediction functions are obtained by using the random forest algorithm. The management tool allows the cardiologist to populate a "supervised database" suitable for machine learning during his or her regular outpatient consultations. The idea comes from the fact that in literature there are a few databases of this type, and they are not scalable to our case.

The closing behavior of mechanical aortic heart valve prostheses.

PubMed

Lu, Po-Chien; Liu, Jia-Shing; Huang, Ren-Hong; Lo, Chi-Wen; Lai, Ho-Cheng; Hwang, Ned H C

2004-01-01

Mechanical artificial heart valves rely on reverse flow to close their leaflets. This mechanism creates regurgitation and water hammer effects that may form cavitations, damage blood cells, and cause thromboembolism. This study analyzes closing mechanisms of monoleaflet (Medtronic Hall 27), bileaflet (Carbo-Medics 27; St. Jude Medical 27; Duromedics 29), and trileaflet valves in a circulatory mock loop, including an aortic root with three sinuses. Downstream flow field velocity was measured via digital particle image velocimetry (DPIV). A high speed camera (PIVCAM 10-30 CCD video camera) tracked leaflet movement at 1000 frames/s. All valves open in 40-50 msec, but monoleaflet and bileaflet valves close in much less time (< 35 msec) than the trileaflet valve (>75 msec). During acceleration phase of systole, the monoleaflet forms a major and minor flow, the bileaflet has three jet flows, and the trileaflet produces a single central flow like physiologic valves. In deceleration phase, the aortic sinus vortices hinder monoleaflet and bileaflet valve closure until reverse flows and high negative transvalvular pressure push the leaflets rapidly for a hard closure. Conversely, the vortices help close the trileaflet valve more softly, probably causing less damage, lessening back flow, and providing a washing effect that may prevent thrombosis formation.

The role of prostaglandins and the hypothalamus in thermoregulation in the lizard, Phrynocephalus przewalskii (Agamidae).

PubMed

Liu, Chongbin; Li, Rende; Liu, Zhonghu; Yin, Shuming; Wang, Ziren

2006-05-01

Typically, small lizards rely heavily on behavioral thermoregulation rather than physiological mechanisms to control their rates of warming and cooling. We tested the hypothesis that prostaglandins participate in mediating the cardiovascular response to heating and cooling and temperature regulating neurons in the hypothalamus of the small lizard Phrynocephalus przewalskii. In vivo and in vitro treatments, heart rates (HRs) were all found to be higher during heating than during cooling, hysteresis was distinct below 30 and 26 degrees Celsius, respectively. In vivo, as administration of COX inhibitor, there were no differences in HR between heating and cooling at any body temperature and administration of agonist prostaglandins only produced a significant effect on HR below 25 degrees Celsius. Single-unit activity was recorded extracellularly in vitro with microelectrodes, found the firing rate of the continuous unit increased 23% when the temperature of the artificial cerebrospinal fluid dropped from 30-20 degrees Celsius. We conclude that prostaglandins appear to play only a limited role in modulating heart activity in Phrynocephalus przewalskii and suggest that cold-sensitive neurons in the preoptic and anterior hypothalamus (PO/AH) are involved in thermoregulatory control during heating or cooling.

An integrated array of microfluidic oxygenators as a neonatal lung assist device: in vitro characterization and in vivo demonstration.

PubMed

Rochow, Niels; Manan, Asmaa; Wu, Wen-I; Fusch, Gerhard; Monkman, Shelley; Leung, Jennifer; Chan, Emily; Nagpal, Dipen; Predescu, Dragos; Brash, John; Selvaganapathy, Ponnambalam Ravi; Fusch, Christoph

2014-10-01

A miniaturized oxygenator device that is perfused like an artificial placenta via the umbilical vessels may have significant potential to save the lives of newborns with respiratory insufficiency. Recently we presented the concept of an integrated modular lung assist device (LAD) that consists of stacked microfluidic single oxygenator units (SOUs) and demonstrated the technical details and operation of SOU prototypes. In this article, we present a LAD prototype that is designed to accommodate the different needs of term and preterm infants by permitting changing of the number of parallel-stacked microfluidic SOUs according to the actual body weight. The SOUs are made of polydimethylsiloxane, arranged in parallel, and connected though 3D-printed polymeric interconnects to form the LAD. The flow characteristics and the gas exchange properties were tested in vitro using human blood. We found that the pressure drop of the LAD increased linearly with flow rate. Gas exchange rates of 2.4-3.8 μL/min/cm(2) (0.3-0.5 mL/kg/min) and 6.4-10.1 μL/min/cm(2) (0.8-1.3 mL/kg/min) for O2 and CO2 , respectively, were achieved. We also investigated protein adsorption to provide preliminary information on the need for application of anticoagulant coating of LAD materials. Albumin adsorption, as measured by gold staining, showed that surface uptake was evenly distributed and occurred at the monolayer level (>0.2 μg/cm(2) ). Finally, we also tested the LAD under in vivo conditions using a newborn piglet model (body weight 1.65-2.0 kg). First, the effect of an arteriovenous bypass via a carotid artery-to-jugular vein shortcut on heart rate and blood pressure was investigated. Heart rate and mean arterial blood pressure remained stable for extracorporeal flow rates of up to 61 mL/kg/min (101 mL/min). Next, the LAD was connected to umbilical vessels (maximum flow rate of 24 mL/min [10.4 mL/kg/min]), and O2 gas exchange was measured under hypoxic conditions (Fi O2  = 0.15) and was found to be 3.0 μL/min/cm(2) . These results are encouraging and support the feasibility of an artificial placental design for an LAD. Copyright © 2014 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Complexity and spectral analysis of the heart rate variability dynamics for distant prediction of paroxysmal atrial fibrillation with artificial intelligence methods.

PubMed

Chesnokov, Yuriy V

2008-06-01

Paroxysmal atrial fibrillation (PAF) is a serious arrhythmia associated with morbidity and mortality. We explore the possibility of distant prediction of PAF by analyzing changes in heart rate variability (HRV) dynamics of non-PAF rhythms immediately before PAF event. We use that model for distant prognosis of PAF onset with artificial intelligence methods. We analyzed 30-min non-PAF HRV records from 51 subjects immediately before PAF onset and at least 45min distant from any PAF event. We used spectral and complexity analysis with sample (SmEn) and approximate (ApEn) entropies and their multiscale versions on extracted HRV data. We used that features to train the artificial neural networks (ANNs) and support vector machine (SVM) classifiers to differentiate the subjects. The trained classifiers were further tested for distant PAF event prognosis on 16 subjects from independent database on non-PAF rhythm lasting from 60 to 320 min before PAF onset classifying the 30-min segments as distant or leading to PAF. We found statistically significant increase in 30-min non-PAF HRV recordings from 51 subjects in the VLF, LF, HF bands and total power (p<0.0001) before PAF event compared to PAF distant ones. The SmEn and ApEn analysis provided significant decrease in complexity (p<0.0001 and p<0.001) before PAF onset. For training ANN and SVM classifiers the data from 51 subjects were randomly split to training, validation and testing. ANN provided better results in terms of sensitivity (Se), specificity (Sp) and positive predictivity (Pp) compared to SVM which became biased towards positive case. The validation results of the ANN classifier we achieved: Se 76%, Sp 93%, Pp 94%. Testing ANN and SVM classifiers on 16 subjects with non-PAF HRV data preceding PAF events we obtained distant prediction of PAF onset with SVM classifier in 10 subjects (58+/-18 min in advance). ANN classifier provided distant prediction of PAF event in 13 subjects (62+/-21 min in advance). From the results of distant PAF prediction we conclude that ANN and SVM classifiers learned the changes in the HRV dynamics immediately before PAF event and successfully identified them during distant PAF prognosis on independent database. This confirms the reported in the literature results that corresponding changes in the HRV data occur about 60 min before PAF onset and proves the possibility of distant PAF prediction with ANN and SVM methods.

Velocity Fluctuations in Helical Propulsion: How Small Can a Propeller Be.

PubMed

Ghosh, Arijit; Paria, Debadrita; Rangarajan, Govindan; Ghosh, Ambarish

2014-01-02

Helical propulsion is at the heart of locomotion strategies utilized by various natural and artificial swimmers. We used experimental observations and a numerical model to study the various fluctuation mechanisms that determine the performance of an externally driven helical propeller as the size of the helix is reduced. From causality analysis, an overwhelming effect of orientational noise at low length scales is observed, which strongly affects the average velocity and direction of motion of a propeller. For length scales smaller than a few micrometers in aqueous media, the operational frequency for the propulsion system would have to increase as the inverse cube of the size, which can be the limiting factor for a helical propeller to achieve locomotion in the desired direction.

Linking environmental variability to population and community dynamics: Chapter 7

USGS Publications Warehouse

Pantel, Jelena H.; Pendleton, Daniel E.; Walters, Annika W.; Rogers, Lauren A.

2014-01-01

Linking population and community responses to environmental variability lies at the heart of ecology, yet methodological approaches vary and existence of broad patterns spanning taxonomic groups remains unclear. We review the characteristics of environmental and biological variability. Classic approaches to link environmental variability to population and community variability are discussed as are the importance of biotic factors such as life history and community interactions. In addition to classic approaches, newer techniques such as information theory and artificial neural networks are reviewed. The establishment and expansion of observing networks will provide new long-term ecological time-series data, and with it, opportunities to incorporate environmental variability into research. This review can help guide future research in the field of ecological and environmental variability.

Shear-stress sensitive lenticular vesicles for targeted drug delivery.

PubMed

Holme, Margaret N; Fedotenko, Illya A; Abegg, Daniel; Althaus, Jasmin; Babel, Lucille; Favarger, France; Reiter, Renate; Tanasescu, Radu; Zaffalon, Pierre-Léonard; Ziegler, André; Müller, Bert; Saxer, Till; Zumbuehl, Andreas

2012-08-01

Atherosclerosis results in the narrowing of arterial blood vessels and this causes significant changes in the endogenous shear stress between healthy and constricted arteries. Nanocontainers that can release drugs locally with such rheological changes can be very useful. Here, we show that vesicles made from an artificial 1,3-diaminophospholipid are stable under static conditions but release their contents at elevated shear stress. These vesicles have a lenticular morphology, which potentially leads to instabilities along their equator. Using a model cardiovascular system based on polymer tubes and an external pump to represent shear stress in healthy and constricted vessels of the heart, we show that drugs preferentially release from the vesicles in constricted vessels that have high shear stress.

Use of implantable telemetry systems for study of cardiovascular phenomena.

NASA Technical Reports Server (NTRS)

Sandler, H.; Fryer, T. B.; Westbrook, R. M.; Stone, H. L.

1972-01-01

Preliminary observations of cardiovascular function have been made in four chimpanzees using multichannel implantable units. Measurements of right- and left-sided pressures were periodically made in these animals over a four-month period, including continuous observations for selected 24-hour periods. Pressures recorded with animals in an awake, unanesthetized, unrestrained state were much lower than pressures reported for restrained animals in similar situations. Diurnal variations of pressure tended to occur, but were not as clear-cut as those reported to occur for humans. The ability to implant a transmitter chronically and receive useful multichannel information in the chimpanzee encourages the future use of such implant devices as part of the control system for an artificial heart or directly for use in man.

Study on Synchronization of the Heart in a Nursing Art.

PubMed

Sakaki, Soh; Ishigame, Atsushi; Majima, Yukie

2016-01-01

Compared to rookie nurses, it is often said that a skilled nurse's injection is less degree of pain. The authors believe that the reason why the pain is reduced is because skilled nurses can make themselves relaxed and synchronize their state to the patients. So, if we can make people relaxed and synchronized intentionally by giving artificial stimulation, the technique will be so valuable not only in the inheritance of injection skills but also in various medical situations including the care of aged, nursing of infant and so on. In this paper, we focused on the synchronization of brain waves, and examined the method of inducing the relaxed state and the synchronization in brain waves of subjects by giving a vibratory stimulation.

Congestive heart failure caused by transvenous pacemaker lead prolapse and associated right ventricular outflow tract obstruction in a dog.

PubMed

Djani, D M; Coleman, A E; Rapoport, G S; Schmiedt, C W; Layher, J; Thomason, J D

2016-12-01

A 16-year-old dog was presented for cough as well as increased respiratory rate and effort three years after implantation of a single-lead transvenous artificial pacemaker system. Thoracic radiographs and echocardiography disclosed prolapse of the pacemaker lead into the main pulmonary artery, causing severe pulmonary insufficiency and right-sided volume overload. Repositioning of the pacemaker lead led to improvement of pulmonary insufficiency and resolution of the dog's clinical signs and cavitary effusions. This case describes a late complication of pacemaker implantation that may be avoided by appropriate use of the manufacturer-provided anchoring sleeve and avoidance of excessive lead redundancy. Copyright © 2016 Elsevier B.V. All rights reserved.

Shear-stress sensitive lenticular vesicles for targeted drug delivery

NASA Astrophysics Data System (ADS)

Holme, Margaret N.; Fedotenko, Illya A.; Abegg, Daniel; Althaus, Jasmin; Babel, Lucille; Favarger, France; Reiter, Renate; Tanasescu, Radu; Zaffalon, Pierre-Léonard; Ziegler, André; Müller, Bert; Saxer, Till; Zumbuehl, Andreas

2012-08-01

Atherosclerosis results in the narrowing of arterial blood vessels and this causes significant changes in the endogenous shear stress between healthy and constricted arteries. Nanocontainers that can release drugs locally with such rheological changes can be very useful. Here, we show that vesicles made from an artificial 1,3-diaminophospholipid are stable under static conditions but release their contents at elevated shear stress. These vesicles have a lenticular morphology, which potentially leads to instabilities along their equator. Using a model cardiovascular system based on polymer tubes and an external pump to represent shear stress in healthy and constricted vessels of the heart, we show that drugs preferentially release from the vesicles in constricted vessels that have high shear stress.

Ultralow-fatigue shape memory alloy films

NASA Astrophysics Data System (ADS)

Chluba, Christoph; Ge, Wenwei; Lima de Miranda, Rodrigo; Strobel, Julian; Kienle, Lorenz; Quandt, Eckhard; Wuttig, Manfred

2015-05-01

Functional shape memory alloys need to operate reversibly and repeatedly. Quantitative measures of reversibility include the relative volume change of the participating phases and compatibility matrices for twinning. But no similar argument is known for repeatability. This is especially crucial for many future applications, such as artificial heart valves or elastocaloric cooling, in which more than 10 million transformation cycles will be required. We report on the discovery of an ultralow-fatigue shape memory alloy film system based on TiNiCu that allows at least 10 million transformation cycles. We found that these films contain Ti2Cu precipitates embedded in the base alloy that serve as sentinels to ensure complete and reproducible transformation in the course of each memory cycle.

Influence of iterative reconstruction on coronary calcium scores at multiple heart rates: a multivendor phantom study on state-of-the-art CT systems.

PubMed

van der Werf, N R; Willemink, M J; Willems, T P; Greuter, M J W; Leiner, T

2017-12-28

The objective of this study was to evaluate the influence of iterative reconstruction on coronary calcium scores (CCS) at different heart rates for four state-of-the-art CT systems. Within an anthropomorphic chest phantom, artificial coronary arteries were translated in a water-filled compartment. The arteries contained three different calcifications with low (38 mg), medium (80 mg) and high (157 mg) mass. Linear velocities were applied, corresponding to heart rates of 0, < 60, 60-75 and > 75 bpm. Data were acquired on four state-of-the-art CT systems (CT1-CT4) with routinely used CCS protocols. Filtered back projection (FBP) and three increasing levels of iterative reconstruction (L1-L3) were used for reconstruction. CCS were quantified as Agatston score and mass score. An iterative reconstruction susceptibility (IRS) index was used to assess susceptibility of Agatston score (IRS AS ) and mass score (IRS MS ) to iterative reconstruction. IRS values were compared between CT systems and between calcification masses. For each heart rate, differences in CCS of iterative reconstructed images were evaluated with CCS of FBP images as reference, and indicated as small (< 5%), medium (5-10%) or large (> 10%). Statistical analysis was performed with repeated measures ANOVA tests. While subtle differences were found for Agatston scores of low mass calcification, medium and high mass calcifications showed increased CCS up to 77% with increasing heart rates. IRS AS of CT1-T4 were 17, 41, 130 and 22% higher than IRS MS . Not only were IRS significantly different between all CT systems, but also between calcification masses. Up to a fourfold increase in IRS was found for the low mass calcification in comparison with the high mass calcification. With increasing iterative reconstruction strength, maximum decreases of 21 and 13% for Agatston and mass score were found. In total, 21 large differences between Agatston scores from FBP and iterative reconstruction were found, while only five large differences were found between FBP and iterative reconstruction mass scores. Iterative reconstruction results in reduced CCS. The effect of iterative reconstruction on CCS is more prominent with low-density calcifications, high heart rates and increasing iterative reconstruction strength.

Effects of Orthostatism and Hemodialysis on Mean Heart Period and Fractal Heart Rate Properties of Chronic Renal Failure Patients.

PubMed

Echeverría, Juan C; Infante, Oscar; Pérez-Grovas, Héctor; González, Hortensia; José, Marco V; Lerma, Claudia

2017-11-01

The aim of this work was to evaluate the short-term fractal index (α 1 ) of heart rate variability (HRV) in chronic renal failure (CRF) patients by identifying the effects of orthostatism and hemodialysis (HD), and by evaluating the correlation between α 1 and the mean RR interval from sinus beats (meanNN). HRV time series were derived from ECG data of 19 CRF patients and 20 age-matched healthy subjects obtained at supine and orthostatic positions (lasting 5 min each). Data from CRF patients were collected before and after HD. α 1 was calculated from each time series and compared by analysis of variance. Pearson's correlations between meanNN and α 1 were calculated using the data from both positions by considering three groups: healthy subjects, CRF before HD and CRF after HD. At supine position, α 1 of CRF patients after HD (1.17 ± 0.30) was larger (P < 0.05) than in healthy subjects (0.89 ± 0.28) but not before HD (1.10 ± 0.34). α 1 increased (P < 0.05) in response to orthostatism in healthy subjects (1.29 ± 0.26) and CRF patients after HD (1.34 ± 0.31), but not before HD (1.25 ± 0.37). Whereas α 1 was correlated (P < 0.05) with the meanNN of healthy subjects (r = -0.562) and CRF patients after HD (r = -0.388), no significance in CRF patients before HD was identified (r = 0.003). Multiple regression analysis confirmed that α 1 was mainly predicted by the orthostatic position (in all groups) and meanNN (healthy subjects and patients after HD), showing no association with the renal disease condition in itself. In conclusion, as in healthy subjects, α 1 of CRF patients correlates with meanNN after HD (indicating a more irregular-like HRV behavior at slower heart rates). This suggests that CRF patients with stable blood pressure preserve a regulatory adaptability despite a shifted setting point of the heart period (i.e., higher heart rate) in comparison with healthy subjects. © 2017 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

[Non-destructive detection research for hollow heart of potato based on semi-transmission hyperspectral imaging and SVM].

PubMed

Huang, Tao; Li, Xiao-yu; Xu, Meng-ling; Jin, Rui; Ku, Jing; Xu, Sen-miao; Wu, Zhen-zhong

2015-01-01

The quality of potato is directly related to their edible value and industrial value. Hollow heart of potato, as a physiological disease occurred inside the tuber, is difficult to be detected. This paper put forward a non-destructive detection method by using semi-transmission hyperspectral imaging with support vector machine (SVM) to detect hollow heart of potato. Compared to reflection and transmission hyperspectral image, semi-transmission hyperspectral image can get clearer image which contains the internal quality information of agricultural products. In this study, 224 potato samples (149 normal samples and 75 hollow samples) were selected as the research object, and semi-transmission hyperspectral image acquisition system was constructed to acquire the hyperspectral images (390-1 040 nn) of the potato samples, and then the average spectrum of region of interest were extracted for spectral characteristics analysis. Normalize was used to preprocess the original spectrum, and prediction model were developed based on SVM using all wave bands, the accurate recognition rate of test set is only 87. 5%. In order to simplify the model competitive.adaptive reweighed sampling algorithm (CARS) and successive projection algorithm (SPA) were utilized to select important variables from the all 520 spectral variables and 8 variables were selected (454, 601, 639, 664, 748, 827, 874 and 936 nm). 94. 64% of the accurate recognition rate of test set was obtained by using the 8 variables to develop SVM model. Parameter optimization algorithms, including artificial fish swarm algorithm (AFSA), genetic algorithm (GA) and grid search algorithm, were used to optimize the SVM model parameters: penalty parameter c and kernel parameter g. After comparative analysis, AFSA, a new bionic optimization algorithm based on the foraging behavior of fish swarm, was proved to get the optimal model parameter (c=10. 659 1, g=0. 349 7), and the recognition accuracy of 10% were obtained for the AFSA-SVM model. The results indicate that combining the semi-transmission hyperspectral imaging technology with CARS-SPA and AFSA-SVM can accurately detect hollow heart of potato, and also provide technical support for rapid non-destructive detecting of hollow heart of potato.

Effect of salivary pellicle on antibacterial activity of novel antibacterial dental adhesives using a dental plaque microcosm biofilm model

PubMed Central

Li, Fang; Weir, Michael D.; Fouad, Ashraf F.; Xu, Hockin H.K.

2014-01-01

Objectives Antibacterial primer and adhesive are promising to inhibit biofilms and caries. Since restorations in vivo are exposed to saliva, one concern is the attenuation of antibacterial activity due to salivary pellicles. The objective of this study was to investigate the effects of salivary pellicles on bonding agents containing a new monomer dimethylaminododecyl methacrylate (DMADDM) or nanoparticles of silver (NAg) against biofilms for the first time. Methods DMADDM and NAg were synthesized and incorporated into Scotchbond Multi-Purpose adhesive and primer. Specimens were either coated or not coated with salivary pellicles. A microcosm biofilm model was used with mixed saliva from ten donors. Two types of culture medium were used: an artificial saliva medium (McBain), and Brain Heart Infusion (BHI) medium without salivary proteins. Metabolic activity, colony-forming units (CFU), and lactic acid production of plaque microcosm biofilms were measured (n = 6). Results Bonding agents containing DMADDM and NAg greatly inhibited biofilm activities, even with salivary pellicles. When using BHI, the pre-coating of salivary pellicles on resin surfaces significantly decreased the antibacterial effect (p < 0.05). When using artificial saliva medium, pre-coating of salivary pellicles on resin did not decrease the antibacterial effect. These results suggest that artificial saliva yielded medium-derived pellicles on resin surfaces, which provided attenuating effects on biofilms similar to salivary pellicles. Compared with the commercial control, the DMADDM-containing bonding agent reduced biofilm CFU by about two orders of magnitude. Significance Novel DMADDM- and NAg-containing bonding agents substantially reduced biofilm growth even with salivary pellicle coating on surfaces, indicating a promising usage in saliva-rich environment. DMADDM and NAg may be useful in a wide range of primers, adhesives and other restoratives to achieve antibacterial and anti-caries capabilities. PMID:24332270

Use of Wearable Sensors and Biometric Variables in an Artificial Pancreas System

PubMed Central

Turksoy, Kamuran; Monforti, Colleen; Park, Minsun; Griffith, Garett; Quinn, Laurie; Cinar, Ali

2017-01-01

An artificial pancreas (AP) computes the optimal insulin dose to be infused through an insulin pump in people with Type 1 Diabetes (T1D) based on information received from a continuous glucose monitoring (CGM) sensor. It has been recognized that exercise is a major challenge in the development of an AP system. The use of biometric physiological variables in an AP system may be beneficial for prevention of exercise-induced challenges and better glucose regulation. The goal of the present study is to find a correlation between biometric variables such as heart rate (HR), heat flux (HF), skin temperature (ST), near-body temperature (NBT), galvanic skin response (GSR), and energy expenditure (EE), 2D acceleration-mean of absolute difference (MAD) and changes in glucose concentrations during exercise via partial least squares (PLS) regression and variable importance in projection (VIP) in order to determine which variables would be most useful to include in a future artificial pancreas. PLS and VIP analyses were performed on data sets that included seven different types of exercises. Data were collected from 26 clinical experiments. Clinical results indicate ST to be the most consistently important (important for six out of seven tested exercises) variable over all different exercises tested. EE and HR are also found to be important variables over several types of exercise. We also found that the importance of GSR and NBT observed in our experiments might be related to stress and the effect of changes in environmental temperature on glucose concentrations. The use of the biometric measurements in an AP system may provide better control of glucose concentration. PMID:28272368

Numerical solution of the incompressible Navier-Stokes equations. Ph.D. Thesis - Stanford Univ., Mar. 1989

NASA Technical Reports Server (NTRS)

Rogers, Stuart E.

1990-01-01

The current work is initiated in an effort to obtain an efficient, accurate, and robust algorithm for the numerical solution of the incompressible Navier-Stokes equations in two- and three-dimensional generalized curvilinear coordinates for both steady-state and time-dependent flow problems. This is accomplished with the use of the method of artificial compressibility and a high-order flux-difference splitting technique for the differencing of the convective terms. Time accuracy is obtained in the numerical solutions by subiterating the equations in psuedo-time for each physical time step. The system of equations is solved with a line-relaxation scheme which allows the use of very large pseudo-time steps leading to fast convergence for steady-state problems as well as for the subiterations of time-dependent problems. Numerous laminar test flow problems are computed and presented with a comparison against analytically known solutions or experimental results. These include the flow in a driven cavity, the flow over a backward-facing step, the steady and unsteady flow over a circular cylinder, flow over an oscillating plate, flow through a one-dimensional inviscid channel with oscillating back pressure, the steady-state flow through a square duct with a 90 degree bend, and the flow through an artificial heart configuration with moving boundaries. An adequate comparison with the analytical or experimental results is obtained in all cases. Numerical comparisons of the upwind differencing with central differencing plus artificial dissipation indicates that the upwind differencing provides a much more robust algorithm, which requires significantly less computing time. The time-dependent problems require on the order of 10 to 20 subiterations, indicating that the elliptical nature of the problem does require a substantial amount of computing effort.

Effect of salivary pellicle on antibacterial activity of novel antibacterial dental adhesives using a dental plaque microcosm biofilm model.

PubMed

Li, Fang; Weir, Michael D; Fouad, Ashraf F; Xu, Hockin H K

2014-02-01

Antibacterial primer and adhesive are promising to inhibit biofilms and caries. Since restorations in vivo are exposed to saliva, one concern is the attenuation of antibacterial activity due to salivary pellicles. The objective of this study was to investigate the effects of salivary pellicles on bonding agents containing a new monomer dimethylaminododecyl methacrylate (DMADDM) or nanoparticles of silver (NAg) against biofilms for the first time. DMADDM and NAg were synthesized and incorporated into Scotchbond Multi-Purpose adhesive and primer. Specimens were either coated or not coated with salivary pellicles. A microcosm biofilm model was used with mixed saliva from ten donors. Two types of culture medium were used: an artificial saliva medium (McBain), and Brain Heart Infusion (BHI) medium without salivary proteins. Metabolic activity, colony-forming units (CFU), and lactic acid production of plaque microcosm biofilms were measured (n=6). Bonding agents containing DMADDM and NAg greatly inhibited biofilm activities, even with salivary pellicles. When using BHI, the pre-coating of salivary pellicles on resin surfaces significantly decreased the antibacterial effect (p<0.05). When using artificial saliva medium, pre-coating of salivary pellicles on resin did not decrease the antibacterial effect. These results suggest that artificial saliva yielded medium-derived pellicles on resin surfaces, which provided attenuating effects on biofilms similar to salivary pellicles. Compared with the commercial control, the DMADDM-containing bonding agent reduced biofilm CFU by about two orders of magnitude. Novel DMADDM- and NAg-containing bonding agents substantially reduced biofilm growth even with salivary pellicle coating on surfaces, indicating a promising usage in saliva-rich environment. DMADDM and NAg may be useful in a wide range of primers, adhesives and other restoratives to achieve antibacterial and anti-caries capabilities. Published by Elsevier Ltd.

Real-time assessment of mental workload using psychophysiological measures and artificial neural networks.

PubMed

Wilson, Glenn F; Russell, Christopher A

The functional state of the human operator is critical to optimal system performance. Degraded states of operator functioning can lead to errors and overall suboptimal system performance. Accurate assessment of operator functional state is crucial to the successful implementation of an adaptive aiding system. One method of determining operators' functional state is by monitoring their physiology. In the present study, artificial neural networks using physiological signals were used to continuously monitor, in real time, the functional state of 7 participants while they performed the Multi-Attribute Task Battery with two levels of task difficulty. Six channels of brain electrical activity and eye, heart and respiration measures were evaluated on line. The accuracy of the classifier was determined to test its utility as an on-line measure of operator state. The mean classification accuracies were 85%, 82%, and 86% for the baseline, low task difficulty, and high task difficulty conditions, respectively. The high levels of accuracy suggest that these procedures can be used to provide accurate estimates of operator functional state that can be used to provide adaptive aiding. The relative contribution of each of the 43 psychophysiological features was also determined. Actual or potential applications of this research include test and evaluation and adaptive aiding implementation.

Data series embedding and scale invariant statistics.

PubMed

Michieli, I; Medved, B; Ristov, S

2010-06-01

Data sequences acquired from bio-systems such as human gait data, heart rate interbeat data, or DNA sequences exhibit complex dynamics that is frequently described by a long-memory or power-law decay of autocorrelation function. One way of characterizing that dynamics is through scale invariant statistics or "fractal-like" behavior. For quantifying scale invariant parameters of physiological signals several methods have been proposed. Among them the most common are detrended fluctuation analysis, sample mean variance analyses, power spectral density analysis, R/S analysis, and recently in the realm of the multifractal approach, wavelet analysis. In this paper it is demonstrated that embedding the time series data in the high-dimensional pseudo-phase space reveals scale invariant statistics in the simple fashion. The procedure is applied on different stride interval data sets from human gait measurements time series (Physio-Bank data library). Results show that introduced mapping adequately separates long-memory from random behavior. Smaller gait data sets were analyzed and scale-free trends for limited scale intervals were successfully detected. The method was verified on artificially produced time series with known scaling behavior and with the varying content of noise. The possibility for the method to falsely detect long-range dependence in the artificially generated short range dependence series was investigated. (c) 2009 Elsevier B.V. All rights reserved.

[A case of cerebral fat embolism after artificial bone replacement operation for femoral head fracture].

PubMed

Kontani, Satoru; Nakamura, Akinobu; Tokumi, Hiroshi; Hirose, Genjirou

2014-01-01

A 83 years old woman was slipped and injured with right femoral neck fracture. After three days from the fracture, she underwent an artificial head bone replacement operation. Immediately after surgery, she complained of chest discomfort, nausea and dyspnea. A few hours later, she became comatose. Brain CT showed no abnormality and clinical diagnosis of heart failure was made without pulmonary embolism on enhanced chest CT. Magnetic resonance imaging (MRI) of the brain next day showed multiple small patchy hyperintense lesion in bilateral hemispheres on diffusion-weighted images (DWI), producing a "star field pattern''. Based on Criteria of Gurd, this patient had one major criterion and four minor criteria. And according to the Criteria of Schonfeld, this patient had 5 points, consistent with clinical diagnosis of fat embolism. Because of these criteria, she was diagnosed as cerebral fat embolism syndrome. We started supported care and edaravon. Two weeks after surgery, her condition recovered and remaind to stuporous state even six month after surgery. We experienced a typical case of cerebral fat embolism, after bone surgery with diagnostic findings on MRI-DWI. Diagnosis of cerebral fat embolism syndrome requires a history of long bone fracture and/or replacing surgery with typical finding on MRI images, such as "star field pattern''.

Deposition of mannose-binding lectin and ficolins and activation of the lectin pathway of complement on the surface of polyurethane tubing used for cardiopulmonary bypass.

PubMed

Eppa, Łukasz; Pągowska-Klimek, Izabela; Świerzko, Anna S; Moll, Maciej; Krajewski, Wojciech R; Cedzyński, Maciej

2018-04-01

The artificial surface used for cardiopulmonary bypass (CPB) is a crucial factor activating the complement system and thus contributing to the generation of a systemic inflammatory response. The activation of classical and alternative pathways on this artificial surface is well known. In contrast, lectin pathway (LP) activation has not been fully investigated, although noted during CPB in several studies. Moreover, we have recently proved the contribution of the LP to the generation of the systemic inflammatory response syndrome after pediatric cardiac surgery. The aim of this study was to assess LP-mediated complement activation on the surface of polyurethane CPB circuit tubing (noncoated Chalice ® ), used for CPB procedures in children with congenital heart disease. We found deposition of mannose-binding lectin, ficolin-1, -2, and -3 on the surface of unused tubing and on tubing used for CPB from a small minority of patients. Furthermore, we observed deposition of complement C4 activation products on tubing used for CPB and previously unused tubing after incubation with normal serum. The latter finding indicates LP activation in vitro on the polyurethane surface. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 1202-1208, 2018. © 2017 Wiley Periodicals, Inc.

Computational Depth of Anesthesia via Multiple Vital Signs Based on Artificial Neural Networks.

PubMed

Sadrawi, Muammar; Fan, Shou-Zen; Abbod, Maysam F; Jen, Kuo-Kuang; Shieh, Jiann-Shing

2015-01-01

This study evaluated the depth of anesthesia (DoA) index using artificial neural networks (ANN) which is performed as the modeling technique. Totally 63-patient data is addressed, for both modeling and testing of 17 and 46 patients, respectively. The empirical mode decomposition (EMD) is utilized to purify between the electroencephalography (EEG) signal and the noise. The filtered EEG signal is subsequently extracted to achieve a sample entropy index by every 5-second signal. Then, it is combined with other mean values of vital signs, that is, electromyography (EMG), heart rate (HR), pulse, systolic blood pressure (SBP), diastolic blood pressure (DBP), and signal quality index (SQI) to evaluate the DoA index as the input. The 5 doctor scores are averaged to obtain an output index. The mean absolute error (MAE) is utilized as the performance evaluation. 10-fold cross-validation is performed in order to generalize the model. The ANN model is compared with the bispectral index (BIS). The results show that the ANN is able to produce lower MAE than BIS. For the correlation coefficient, ANN also has higher value than BIS tested on the 46-patient testing data. Sensitivity analysis and cross-validation method are applied in advance. The results state that EMG has the most effecting parameter, significantly.

Computational Depth of Anesthesia via Multiple Vital Signs Based on Artificial Neural Networks

PubMed Central

Sadrawi, Muammar; Fan, Shou-Zen; Abbod, Maysam F.; Jen, Kuo-Kuang; Shieh, Jiann-Shing

2015-01-01

This study evaluated the depth of anesthesia (DoA) index using artificial neural networks (ANN) which is performed as the modeling technique. Totally 63-patient data is addressed, for both modeling and testing of 17 and 46 patients, respectively. The empirical mode decomposition (EMD) is utilized to purify between the electroencephalography (EEG) signal and the noise. The filtered EEG signal is subsequently extracted to achieve a sample entropy index by every 5-second signal. Then, it is combined with other mean values of vital signs, that is, electromyography (EMG), heart rate (HR), pulse, systolic blood pressure (SBP), diastolic blood pressure (DBP), and signal quality index (SQI) to evaluate the DoA index as the input. The 5 doctor scores are averaged to obtain an output index. The mean absolute error (MAE) is utilized as the performance evaluation. 10-fold cross-validation is performed in order to generalize the model. The ANN model is compared with the bispectral index (BIS). The results show that the ANN is able to produce lower MAE than BIS. For the correlation coefficient, ANN also has higher value than BIS tested on the 46-patient testing data. Sensitivity analysis and cross-validation method are applied in advance. The results state that EMG has the most effecting parameter, significantly. PMID:26568957

Predicting non-melanoma skin cancer via a multi-parameterized artificial neural network.

PubMed

Roffman, David; Hart, Gregory; Girardi, Michael; Ko, Christine J; Deng, Jun

2018-01-26

Ultraviolet radiation (UVR) exposure and family history are major associated risk factors for the development of non-melanoma skin cancer (NMSC). The objective of this study was to develop and validate a multi-parameterized artificial neural network based on available personal health information for early detection of NMSC with high sensitivity and specificity, even in the absence of known UVR exposure and family history. The 1997-2015 NHIS adult survey data used to train and validate our neural network (NN) comprised of 2,056 NMSC and 460,574 non-cancer cases. We extracted 13 parameters for our NN: gender, age, BMI, diabetic status, smoking status, emphysema, asthma, race, Hispanic ethnicity, hypertension, heart diseases, vigorous exercise habits, and history of stroke. This study yielded an area under the ROC curve of 0.81 and 0.81 for training and validation, respectively. Our results (training sensitivity 88.5% and specificity 62.2%, validation sensitivity 86.2% and specificity 62.7%) were comparable to a previous study of basal and squamous cell carcinoma prediction that also included UVR exposure and family history information. These results indicate that our NN is robust enough to make predictions, suggesting that we have identified novel associations and potential predictive parameters of NMSC.

Detection of apnea using a short-window FFT technique and an artificial neural network

NASA Astrophysics Data System (ADS)

Waldemark, Karina E.; Agehed, Kenneth I.; Lindblad, Thomas; Waldemark, Joakim T. A.

1998-03-01

Sleep apnea is characterized by frequent prolonged interruptions of breathing during sleep. This syndrome causes severe sleep disorders and is often responsible for development of other diseases such as heart problems, high blood pressure and daytime fatigue, etc. After diagnosis, sleep apnea is often successfully treated by applying positive air pressure (CPAP) to the mouth and nose. Although effective, the (CPAP) equipment takes up a lot of space and the connected mask causes a lot of inconvenience for the patients. This raised interest in developing new techniques for treatment of sleep apnea syndrome. Several studies have indicated that electrical stimulation of the hypoglossal nerve and muscle in the tongue may be a useful method for treating patients with severe sleep apnea. In order to be able to successfully prevent the occurrence of apnea it is necessary to have some technique for early and fast on-line detection or prediction of the apnea events. This paper suggests using measurements of respiratory airflow (mouth temperature). The signal processing for this task includes the use of a short window FFT technique and uses an artificial back propagation neural net to model or predict the occurrence of apneas. The results show that early detection of respiratory interruption is possible and that the delay time for this is small.

In vitro evaluation of valve hemodynamics in the pediatric pulmonary outflow tract

NASA Astrophysics Data System (ADS)

Schiavone, Nicole; Elkins, Chris; McElhinney, Doff; Eaton, John; Marsden, Alison

2016-11-01

Tetraology of Fallot (ToF) is a congenital heart disease that affects 1 in every 2500 newborns each year and requires surgical repair of the right ventricular outflow tract (RVOT) and subsequent placement of an artificial pulmonary valve. While a wide variety of artificial valves are available, essentially all of them become subject to degradation and dysfunction during the patient's lifetime, which leads to additional interventions. However, there is little understanding about the mechanical function of replacement pulmonary valves and no quantitative placement guidelines to ensure maximum failure-free lifetime. This work aims to experimentally assess the biomechanics of pulmonary valves in realistic RVOT geometries using magnetic resonance velocimetry (MRV), which can measure 3D, three-component phase-averaged velocity fields. The RVOT geometries are constructed using 3D printing, allowing for variation in crucial geometric parameters such as the radius of curvature of the main pulmonary artery (MPA) and the dilation of the artery downstream of the valve. A St. Jude Medical Epic valve is secured inside the RVOT geometry and can be interchanged, allowing for variation of the ratio between valve diameter and MPA diameter. This work will discuss the use of MRV to capture the flow structure in the RVOT and evaluate pulmonary valve performance under different conditions.

The Ventricular Assist Device in the Life of the Child: A Phenomenological Pediatric Study.

PubMed

van Manen, Michael A

2017-05-01

What is it like for a child to live with an artificial heart? The use of some medical therapies in children requires developmental considerations, is associated with psychosocial consequences, and calls for ethical sensitivities. A critical case is the ventricular assist device (VAD), a mechanical pump used to support the functioning of a failing heart. As a pediatric therapy, the device can be used as a temporary solution for poor heart function, a bridge to transplantation or recovery, or as a destination therapy. While the mechanical-technical operation of the VAD is well understood, the clinical-technical aspects of young people living with this device are largely unexplored. Drawing on interviews of school-aged children, the aim of this phenomenological study is to explore how a VAD may structure or condition a child's meaningful experience of their world outside the hospital. The driveline of an implanted VAD is the peripheral attachment, extruding through the skin to connect the controller-power supply. The materiality of the device may be interruptive, restrictive, and disturbing to the psycho-physical being and sense of self-identity of the child as a child. And while a child equipped with a VAD is not necessarily conspicuous among other children, the child may experience the device as an exposing presence, while living with the worry of a caregiver who takes on the role not simply of parent but of watchful health professional. A phenomenological understanding of the VAD should assist parents and caregiving health professionals knowing how to deal with specific issues arising in the life of the VAD child.