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Zhou M, Qi Z, Xia Z, Li Y, Ling W, Yang J, Yang Z, Pei J, Wu D, Huo W, Huang X. Miniaturized soft centrifugal pumps with magnetic levitation for fluid handling. SCIENCE ADVANCES 2021; 7:eabi7203. [PMID: 34705505 PMCID: PMC8550243 DOI: 10.1126/sciadv.abi7203] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Centrifugal pumps are essential mechanical components for liquid delivery in many biomedical systems whose miniaturization can promote innovative disease treatment approaches. However, centrifugal pumps are predominately constructed by rigid and bulky components. Here, we combine the soft materials and flexible electronics to achieve soft magnetic levitation micropumps (SMLMs) that are only 1.9 to 12.8 grams in weight. The SMLMs that rotate at a rotation speed of 1000 revolutions per min to pump liquids with various viscosities ranging from 1 to 6 centipoise can be used in assisting dialysis, blood circulation, and skin temperature control because of excellent biocompatibility with no organ damage. The development of SMLMs not only demonstrates the possibility to replace rigid rotating structures with soft materials for handling large volumes of fluids but also indicates the potential for fully flexible artificial organs that may revolutionize health care and improve the well-being of patients.
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Affiliation(s)
- Mingxing Zhou
- Department of Biomedical Engineering, Tianjin University, 92 Weijin Road, Tianjin 300072, China
| | - Zhijie Qi
- Department of Biomedical Engineering, Tianjin University, 92 Weijin Road, Tianjin 300072, China
| | - Zhiqiang Xia
- Department of Biomedical Engineering, Tianjin University, 92 Weijin Road, Tianjin 300072, China
| | - Ya Li
- Department of Biomedical Engineering, Tianjin University, 92 Weijin Road, Tianjin 300072, China
| | - Wei Ling
- Department of Biomedical Engineering, Tianjin University, 92 Weijin Road, Tianjin 300072, China
| | - Jingxuan Yang
- Department of Biomedical Engineering, Tianjin University, 92 Weijin Road, Tianjin 300072, China
| | - Zhen Yang
- Department of Biomedical Engineering, Tianjin University, 92 Weijin Road, Tianjin 300072, China
| | - Ji Pei
- National Research Center of Pumps, Jiangsu University, 301 Xuefu Road, Zhenjiang, Jiangsu 212013, China
| | - Dazhuan Wu
- College of Energy Engineering, Zhejiang University, 38 Zheda Road, Hangzhou, Zhejiang 310027, China
| | - Wenxing Huo
- Department of Biomedical Engineering, Tianjin University, 92 Weijin Road, Tianjin 300072, China
- Corresponding author. (W.H.); (X.H.)
| | - Xian Huang
- Department of Biomedical Engineering, Tianjin University, 92 Weijin Road, Tianjin 300072, China
- Corresponding author. (W.H.); (X.H.)
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Kannojiya V, Das AK, Das PK. Comparative assessment of different versions of axial and centrifugal LVADs: A review. Artif Organs 2021; 45:665-681. [PMID: 33434332 DOI: 10.1111/aor.13914] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 11/18/2020] [Accepted: 01/04/2021] [Indexed: 02/06/2023]
Abstract
Continuous-flow left ventricular assist devices (LVADs) have gained tremendous acceptance for the treatment of end-stage heart failure patients. Among different versions, axial flow and centrifugal flow LVADs have shown remarkable potential for clinical implants. It is also very crucial to know which device serves its purpose better to treat heart failure patients. A thorough comparison of axial and centrifugal LVADs, which may guide doctors in deciding before the implant, still lacks in the literature. In this work, an assessment of axial and centrifugal LVADs has been made to suggest a better device by comparing their engineering, clinical, and technological development of design aspects. Hydrodynamic and hemodynamic aspects for both types of pumps are discussed along with their biocompatibility, bearing types, and sizes. It has been observed numerically that centrifugal LVADs perform better over axial LVADs in every engineering aspect like higher hydraulic efficiency, better characteristics curve, lesser power intake, and also lesser blood damage. However, the clinical outcomes suggest that centrifugal LVADs experience higher events of infections, renal, and respiratory dysfunction. In contrast, axial LVADs encountered higher bleeding and cardiac arrhythmia. Moreover, recent technological developments suggested that magnetic type bearings along with biocompatible coating improve the life of LVADs.
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Affiliation(s)
- Vikas Kannojiya
- Mechanical and Industrial Engineering Department, IIT Roorkee, Roorkee, India
| | - Arup Kumar Das
- Mechanical and Industrial Engineering Department, IIT Roorkee, Roorkee, India
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Köhne I. Kontinuierlich fördernde Blutpumpen für die Langzeitherzunterstützung. ZEITSCHRIFT FUR HERZ THORAX UND GEFASSCHIRURGIE 2020. [DOI: 10.1007/s00398-020-00398-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Hetzer R, Javier MFDM, Javier Delmo EM. Pediatric ventricular assist devices: what are the key considerations and requirements? Expert Rev Med Devices 2019; 17:57-74. [PMID: 31779486 DOI: 10.1080/17434440.2020.1699404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Introduction: The development of ventricular assist devices (VADs) have enabled myocardial recovery and improved patient survival until heart transplantation. However, device options remain limited for children and lag in development.Areas covered: This review focuses on the evolution of pediatric VADs in becoming to be an accepted treatment option in advanced heart failure, discusses the classification of VADs available for children, i.e. types of pumps and duration of support, and defines implantation indications and explantation criteria, describes attendant complications and long-term outcome of VAD support. Furthermore, we emphasize the key considerations and requirements in the application of these devices in infants, children and adolescents.Expert opinion: Increasing use of VADs has facilitated a leading edge in management of advanced heart failure either as a bridge to transplantation or as a bridge to myocardial recovery. In newborns and small children, the EXCOR Pediatric VAD remains the only reliable option. In some patients ventricular unloading may lead to complete myocardial recovery. There is a strong need for pumps that are fully implantable, suitable for single ventricle physiology, such as the right ventricle.
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Affiliation(s)
- Roland Hetzer
- Department of Cardiothoracic and Vascular Surgery, Cardio Centrum Berlin, Berlin, Germany
| | | | - Eva Maria Javier Delmo
- Department of Cardiothoracic and Vascular Surgery, Cardio Centrum Berlin, Berlin, Germany
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5
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Readmissions after continuous flow left ventricular assist device implantation. J Artif Organs 2017; 20:311-317. [DOI: 10.1007/s10047-017-0975-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 07/20/2017] [Indexed: 10/19/2022]
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Stockhausen S, Ortmann J, Kernbach-Wighton G, Madea B. Tod eines 79 Jahre alten Mannes mit einem linksventrikulären Herzunterstützungssystem. Rechtsmedizin (Berl) 2015. [DOI: 10.1007/s00194-015-0061-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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7
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Abstract
The use of Extracorporeal Life Support (ECLS) in children and adults has markedly increased during the past few years with over 4000 patients placed on ECLS every year in over 200 centers. This article focuses on updates to the physiology and mechanics of ECLS with use of magnetically levitated centrifugal pumps, hollow-fiber gas-exchange devices, and bi-caval dual-lumen catheters. We also explore controversies in management including indications, cannulation approaches, renal replacement, monitoring of anticoagulation, early ambulation, and termination of ECLS. Finally, we present changes in the systems that provide ECLS including the single-provider model and regionalization of care.
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Affiliation(s)
- Samir K Gadepalli
- Section of Pediatric Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan.
| | - Ronald B Hirschl
- Section of Pediatric Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan
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Covering implantable left ventricular assist device (DuraHeart®) with free flap. J Artif Organs 2014; 18:114-9. [DOI: 10.1007/s10047-014-0812-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 12/09/2014] [Indexed: 11/27/2022]
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An insight into short- and long-term mechanical circulatory support systems. Clin Res Cardiol 2014; 104:95-111. [PMID: 25349064 DOI: 10.1007/s00392-014-0771-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 10/14/2014] [Indexed: 10/24/2022]
Abstract
Cardiogenic shock due to acute myocardial infarction, postcardiotomy syndrome following cardiac surgery, or manifestation of heart failure remains a clinical challenge with high mortality rates, despite ongoing advances in surgical techniques, widespread use of primary percutaneous interventions, and medical treatment. Clinicians have, therefore, turned to mechanical means of circulatory support. At present, a broad range of devices are available, which may be extracorporeal, implantable, or percutaneous; temporary or long term. Although counter pulsation provided by intra-aortic balloon pump (IABP) and comprehensive mechanical support for both the systemic and the pulmonary circulation through extracorporeal membrane oxygenation (ECMO) remain a major tool of acute care in patients with cardiogenic shock, both before and after surgical or percutaneous intervention, the development of devices such as the Impella or the Tandemheart allows less invasive forms of temporary support. On the other hand, concerning mid-, or long-term support, left ventricular assist devices have evolved from a last resort life-saving therapy to a well-established viable alternative for thousands of heart failure patients caused by the shortage of donor organs available for transplantation. The optimal selection of the assist device is based on the initial consideration according to hemodynamic situation, comorbidities, intended time of use and therapeutic options. The present article offers an update on currently available mechanical circulatory support systems (MCSS) for short and long-term use as well as an insight into future perspectives.
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Current status of third-generation implantable left ventricular assist devices in Japan, Duraheart and HeartWare. Surg Today 2014; 45:672-81. [DOI: 10.1007/s00595-014-0957-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2014] [Accepted: 05/12/2014] [Indexed: 10/24/2022]
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Kimura M, Kinoshita O, Nawata K, Nishimura T, Hatano M, Imamura T, Endo M, Kagami Y, Kubo H, Kashiwa K, Kinugawa K, Kyo S, Komuro I, Ono M. Midterm outcome of implantable left ventricular assist devices as a bridge to transplantation: Single-center experience in Japan. J Cardiol 2014; 65:383-9. [PMID: 25034705 DOI: 10.1016/j.jjcc.2014.06.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Revised: 05/15/2014] [Accepted: 06/12/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Two implantable continuous-flow left ventricular assist devices (LVADs), DuraHeart (Terumo Heart, Ann Arbor, MI, USA) and EVAHEART (Sun Medical, Nagano, Japan), were approved in Japan in April 2011. We analyzed the midterm outcome of patients implanted with these implantable LVADs at the University of Tokyo Hospital. METHODS AND RESULTS A total of 31 patients who underwent implantation of LVADs (10 DuraHeart, 21 EVAHEART) as a bridge to transplantation at our institution between April 2011 and August 2013 were retrospectively reviewed. All patients were followed up through December 2013. Seven patients underwent conversions from NIPRO paracorporeal LVAD (Nipro, Osaka, Japan) to an implantable LVAD. The mean observation period was 483±239 days (41.0 patient years). Eight patients were transplanted and one patient showed functional recovery with subsequent LVAD explantation. Four patients died due to cerebrovascular accident, empyema, or device malfunction due to pump thrombosis after cerebral bleeding. Kaplan-Meier analysis revealed 6-, 12-, and 24-month survival rates of 93%, 86%, and 86%, respectively. The rates of freedom from cerebrovascular accidents and device-related infections at 1 year after LVAD implantation were 65% and 36%, respectively. Twenty-nine patients were discharged home after LVAD implantation. During the period of this study, there were 59 readmissions (53 urgent, 6 elective) among 22 patients (76%). The overall and urgent readmission rates were 1.66 and 1.49 per patient year, respectively. The common reason for readmission was device-related infection (31%), followed by cerebrovascular accidents (17%). The total out-of-hospital time after the primary discharge was 90%. CONCLUSIONS Our midterm survival rate after LVAD implantation is satisfactory. However, patients undergoing LVAD support were often readmitted with adverse events.
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Affiliation(s)
- Mitsutoshi Kimura
- Department of Cardiovascular Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Osamu Kinoshita
- Department of Cardiovascular Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kan Nawata
- Department of Cardiovascular Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takashi Nishimura
- Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Cardiac Surgery, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
| | - Masaru Hatano
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Teruhiko Imamura
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Miyoko Endo
- Department of Organ Transplantation, The University of Tokyo Hospital, Tokyo, Japan
| | - Yukie Kagami
- Department of Organ Transplantation, The University of Tokyo Hospital, Tokyo, Japan
| | - Hitoshi Kubo
- Department of Medical Engineering, The University of Tokyo Hospital, Tokyo, Japan
| | - Koichi Kashiwa
- Department of Medical Engineering, The University of Tokyo Hospital, Tokyo, Japan
| | - Koichiro Kinugawa
- Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shunei Kyo
- Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Cardiac Surgery, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
| | - Issei Komuro
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Minoru Ono
- Department of Cardiovascular Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
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Morshuis M, Schoenbrodt M, Nojiri C, Roefe D, Schulte-Eistrup S, Boergermann J, Gummert JF, Arusoglu L. DuraHeart™ magnetically levitated centrifugal left ventricular assist system for advanced heart failure patients. Expert Rev Med Devices 2014; 7:173-83. [DOI: 10.1586/erd.09.68] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Paracorporeal ventricular assist device as a bridge to transplant candidacy in the era of implantable continuous-flow ventricular assist device. J Artif Organs 2013; 17:16-22. [DOI: 10.1007/s10047-013-0731-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 09/05/2013] [Indexed: 10/26/2022]
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Yasui K, Kosaka R, Nishida M, Maruyama O, Kawaguchi Y, Yamane T. Optimal design of the hydrodynamic multi-arc bearing in a centrifugal blood pump for the improvement of bearing stiffness and hemolysis level. Artif Organs 2013; 37:768-77. [PMID: 23980526 DOI: 10.1111/aor.12163] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The purpose of the present study is to establish an optimal design of the multi-arc hydrodynamic bearing in a centrifugal blood pump for the improvement of bearing stiffness and hemolysis level. The multi-arc bearing was designed to fulfill the required specifications: (i) ensuring the uniform bearing stiffness for various bearing angles; (ii) ensuring a higher bearing stiffness than the centrifugal force to prevent impeller whirl; and (iii) adjusting the bearing clearance as much as possible to reduce hemolysis. First, a numerical analysis was performed to optimize three design parameters of the multi-arc bearing: number of arcs N, bearing clearance C, and groove depth H. To validate the accuracy of the numerical analysis, the impeller trajectories for six pump models were measured. Finally, an in vitro hemolysis test was conducted to evaluate the hemolytic property of the multi-arc bearing. As a result of the numerical analysis, the optimal parameter combination was determined as follows: N=4, C=100 μm, and H ≥ 100 μm. In the measurements of the impeller trajectory, the optimal parameter combination was found to be as follows: N=4, C=90 μm, and H=100 μm. This result demonstrated the high reliability of the numerical analysis. In the hemolysis test, the parameter combination that achieved the smallest hemolysis was obtained as follows: N=4, C=90 μm, and H=100 μm. In conclusion, the multi-arc bearing could be optimized for the improvement of bearing stiffness and hemolysis level.
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Yano T, Funayama M, Sudo S, Mitamura Y. Analysis of flow within a left ventricle model fully assisted with continuous flow through the aortic valve. Artif Organs 2012; 36:714-23. [PMID: 22882441 DOI: 10.1111/j.1525-1594.2012.01513.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Blood compatibility of a ventricular assist device (VAD) depends on the dynamics of blood flow. The focus in most previous studies was on blood flow in the VAD. However, the tip shape and position of the VAD inflow cannula influence the dynamics of intraventricular blood flow and thus thrombus formation in the ventricle. In this study, blood flow in the left ventricle (LV) under support with a catheter-type continuous flow blood pump was investigated. The flow field was analyzed both numerically and experimentally to investigate the effects of catheter tip shape and its insertion depth on intraventricular flow patterns. A computational model of the LV cavity with a simplified shape was constructed using computer-aided design software. Models of catheters with three different tip shapes were constructed and each was integrated to the LV model. In addition, three variations of insertion depth were prepared for all models. The fully supported intraventricular flow field was calculated by computational fluid dynamics (CFD). A transparent LV model made of silicone was also fabricated to analyze the intraventricular flow field by the particle image velocimetry technique. A mock circulation loop was constructed and water containing tracer particles was circulated in the loop. The motion of particles in the LV model was recorded with a digital high-speed video camera and analyzed to reveal the flow field. The results of numerical and experimental analyses indicated the formation of two large vortices in the bisector plane of the mitral and aortic valve planes. The shape and positioning of the catheter tip affected the flow distribution in the LV, and some of these combinations elongated the upper vortex toward the ventricular apex. Assessment based on average wall shear stress on the LV wall indicated that the flow distribution improved the washout effect. The flow patterns obtained from flow visualization coincided with those calculated by CFD analysis. Through these comparisons, the numerical analysis was validated. In conclusion, results of these numerical and experimental analyses of flow field in the LV cavity provide useful information when designing catheter-type VADs.
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Affiliation(s)
- Tetsuya Yano
- Faculty of Systems Science and Technology, Akita Prefectural University, Yuri-Honjo, Akita, Japan.
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Third-generation continuous flow left ventricular assist devices. INNOVATIONS-TECHNOLOGY AND TECHNIQUES IN CARDIOTHORACIC AND VASCULAR SURGERY 2012; 5:250-8. [PMID: 22437454 DOI: 10.1097/imi.0b013e3181ee77a1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Tremendous advances have been made in the treatment of end-stage heart failure patients with left ventricular assist devices (LVADs). An important factor playing a role in the improved clinical outcomes is the development of continuous flow, rotary LVADs. New technology using magnetic levitation and hydrodynamic suspension to eliminate contact bearings offers the potential of more durable and efficacious mechanical circulatory blood pumps. Clinical trials evaluating these novel "third-generation" LVADs are in progress.
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Spiliopoulos K, Giamouzis G, Karayannis G, Karangelis D, Koutsias S, Kalogeropoulos A, Georgiopoulou V, Skoularigis J, Butler J, Triposkiadis F. Current status of mechanical circulatory support: a systematic review. Cardiol Res Pract 2012; 2012:574198. [PMID: 22970403 PMCID: PMC3433124 DOI: 10.1155/2012/574198] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Accepted: 07/09/2012] [Indexed: 12/22/2022] Open
Abstract
Heart failure is a major public health problem and its management requires a significant amount of health care resources. Even with administration of the best available medical treatment, the mortality associated with the disease remains high. As therapeutical strategies for heart failure have been refined, the number of patients suffering from the disease has expanded dramatically. Although heart transplantation still represents the gold standard therapeutical approach, the implantation of mechanical circulatory support devices (MCSDs) evolved to a well-established management for this disease. The limited applicability of heart transplantation caused by a shortage of donor organs and the concurrent expand of the patient population with end-stage heart failure led to a considerable utilization of MCSDs. This paper outlines the current status of mechanical circulatory support.
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Affiliation(s)
- Kyriakos Spiliopoulos
- Department of Thoracic and Cardiovascular Surgery, Larissa University Hospital, P.O. Box 1425, 411 10 Larissa, Greece
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Boehning F, Timms DL, Amaral F, Oliveira L, Graefe R, Hsu PL, Schmitz-Rode T, Steinseifer U. Evaluation of Hydraulic Radial Forces on the Impeller by the Volute in a Centrifugal Rotary Blood Pump. Artif Organs 2011; 35:818-25. [DOI: 10.1111/j.1525-1594.2011.01312.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Timms D. A review of clinical ventricular assist devices. Med Eng Phys 2011; 33:1041-7. [PMID: 21665512 DOI: 10.1016/j.medengphy.2011.04.010] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2010] [Revised: 04/18/2011] [Accepted: 04/23/2011] [Indexed: 11/18/2022]
Abstract
Given the limited availability of donor hearts, ventricular assist device (VAD) therapy is fast becoming an accepted alternative treatment strategy to treat end-stage heart failure. The field of mechanical ventricular assistance is littered with novel and unique ideas either based on volume displacement or rotary pump technology, which aim to sufficiently restore cardiac output. However, only a select few have made the transition to the clinical arena. Clinical implants were initially dominated by the FDA approved volume displacement Thoratec HeartMate I, IVAD, and PVAD, whilst Berlin Heart's EXCOR, and Abiomed's BVS5000 and AB5000 offered suitable alternatives. However, limitations associated with an inherently large size and reduced lifetime of these devices stimulated the development and subsequent implantation of rotary blood pump (RBP) technology. Almost all of the reviewed RBPs are clinically available in Europe, whilst many are still undergoing clinical trial in the USA. Thoratec's HeartMate II is currently the only rotary device approved by the FDA, and has supported the highest number of patients to date. This pump is joined by MicroMed Cardiovascular's Heart Assist 5 Adult VAD, Jarvik Heart's Jarvik 2000 FlowMaker and Berlin Heart's InCOR as the axial flow devices under investigation in the USA. More recently developed radial flow devices such as WorldHeart's Levacor, Terumo's DuraHeart, and HeartWare's HVAD are increasing in their clinical trial patient numbers. Finally CircuLite's Synergy and Abiomed's Impella are two mixed flow type devices designed to offer partial cardiac support to less sick patients. This review provides a brief overview of the volume displacement and rotary devices which are either clinically available, or undergoing the advanced stages of human clinical trials.
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Affiliation(s)
- Daniel Timms
- ICET Laboratory, Critical Care Research Group, The Prince Charles Hospital and University of Queensland, Brisbane, Australia.
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Hatano M, Kinugawa K, Shiga T, Kato N, Endo M, Hisagi M, Nishimura T, Yao A, Hirata Y, Kyo S, Ono M, Nagai R. Less frequent opening of the aortic valve and a continuous flow pump are risk factors for postoperative onset of aortic insufficiency in patients with a left ventricular assist device. Circ J 2011; 75:1147-55. [PMID: 21378448 DOI: 10.1253/circj.cj-10-1106] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Postoperative development of aortic insufficiency (AI) after implantation of left ventricular assist devices (LVADs) has recently been recognized, but the devices in the previous reports have been limited to the HeartMate I or II. The purposes of this study were to determine whether AI develops with other types of LVADs and to elucidate the factors associated with the development of AI. METHODS AND RESULTS Thirty-seven patients receiving LVADs without evident abnormalities in native aortic valves were enrolled (pulsatile flow LVAD [TOYOBO]: 76%, continuous flow LVAD [EVAHEART, DuraHeart, Jarvik2000, HeartMate II]: 24%). Frequency of aortic valve opening and grade of AI were evaluated by the most recent echocardiography during LVAD support. None of the patients had more than trace AI preoperatively. During LVAD support AI >- grade 2 developed in 9 patients (24%) across all 5 types of devices. More severe grade of AI correlated with higher plasma B-type natriuretic peptide concentration (r = 0.53, P < 0.01) and with less frequent of the aortic valve (r = 0.45, P < 0.01). Multivariate analysis revealed that lower preoperative left ventricular ejection fraction and a continuous flow device type were independent risk factors for higher incidence of AI. CONCLUSIONS AI, which is hemodynamically significant, develops after implantation of various types of LVADs. Physicians need to be more alert to the development of AI particularly with continuous flow devices.
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Affiliation(s)
- Masaru Hatano
- Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo, Japan
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Rasalingam R, Johnson SN, Bilhorn KR, Huang PH, Makan M, Moazami N, Pérez JE. Transthoracic Echocardiographic Assessment of Continuous-Flow Left Ventricular Assist Devices. J Am Soc Echocardiogr 2011; 24:135-48. [DOI: 10.1016/j.echo.2010.11.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Indexed: 10/18/2022]
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Kurihara C, Ono M, Nishimura T, Saito A, Taketani T, Hisagi M, Nawata K, Kinoshita O, Morota T, Motomura N, Kyo S. Use of DuraHeart® support for more than 1 year as the first successful bridge to heart transplantation in Japan. J Artif Organs 2010; 14:67-9. [DOI: 10.1007/s10047-010-0524-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2010] [Accepted: 10/20/2010] [Indexed: 11/30/2022]
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Abstract
Although heart transplantation is the gold standard for the treatment of advanced stage heart failure, the implantation of mechanical circulatory support devices (MCSDs) has become a well-established therapy for this disease. As the population of patients with severe heart failure has grown, the utilization of MCSDs has increased considerably. That trend is expected to continue, especially in light of dramatic advances in MCSD technology. This review outlines the current status and future directions of mechanical circulatory support therapy in the setting of a constantly evolving field of supportive devices and adjuvant therapies.
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Affiliation(s)
- J Raymond Fitzpatrick Iii
- Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
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Shiga T, Kinugawa K, Hatano M, Yao A, Nishimura T, Endo M, Kato N, Hirata Y, Kyo S, Ono M, Nagai R. Age and preoperative total bilirubin level can stratify prognosis after extracorporeal pulsatile left ventricular assist device implantation. Circ J 2010; 75:121-8. [PMID: 21116070 DOI: 10.1253/circj.cj-10-0770] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND In Japan, the TOYOBO left ventricular assist device (LVAD) has been commercially available for heart failure patients as of 2010, but clinical risk stratification before implantation has not been widely performed. METHODS AND RESULTS In the present study data from 47 patients (age 38.6 ± 14.6 [SD] years, male 74.5%, non-ischemic 74.5%) implanted with a TOYOBO LVAD between November 2002 and February 2010 were analyzed. Kaplan-Meier survival analysis showed significantly higher mortality in the patients who had cardiogenic shock preoperatively (P = 0.031). Multivariate analysis revealed that the preoperative total bilirubin level (odds ratio [OR] 1.312, P < 0.001) and age (OR 1.076, P = 0.013) were independent risk factors for death. Perioperative necessity of a right ventricular assist device was also an independent risk factor for poor prognosis. CONCLUSIONS LVAD implantation is preferable before the patient experiences hemodynamic collapse. The preoperative total bilirubin level can be used to predict prognosis after device implantation in end-stage heart failure patients.
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Affiliation(s)
- Taro Shiga
- Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
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25
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Higaki N, Shiba K. Analysis of specific absorption rate and current density in biological tissues surrounding energy transmission transformer for an artificial heart: using magnetic resonance imaging-based human body model. Artif Organs 2010; 34:E1-9. [PMID: 20420594 DOI: 10.1111/j.1525-1594.2009.00916.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The transcutaneous energy transmission system used for artificial hearts is a transmission system that uses electromagnetic induction. Use of the TETS improves quality of life and reduces the risk of infection caused by percutaneous connections. This article reports the changes in the electromagnetic effects of TETS that influence a human body when the locations of the air-core coils of the transcutaneous transformer are changed. The specific absorption rate and current density in a model consisting of a human trunk that included 24 different organs are analyzed using an electromagnetic simulator. The air-core coils are located on the pectoralis major muscle near the collarbone in model 1, whereas they are located on the axillary region of the serratus anterior muscle, which overlies the rib in model 2. The maximum current densities in models 1 and 2 are 5.2 A/m(2) and 6.1 A/m(2), respectively. The current density observed in model 2 slightly exceeds the limiting value prescribed by International Commission on Non-Ionizing Radiation Protection (ICNIRP). When the volumes of biological tissues whose current densities exceed the limiting value of current density for general public exposure are compared, the volume in model 2 (156.1 cm(3)) is found to be larger than that in model 1 (93.7 cm(3)). Hence, it is speculated that the presence of the ribs caused an increase in the current density. Therefore, it is concluded that model 1 satisfies the ICNIRP standards.
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Affiliation(s)
- Naoya Higaki
- Graduate School of Engineering, Hiroshima University, Higashi-Hiroshima-shi, Hiroshima, Japan
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26
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Thunberg CA, Gaitan BD, Arabia FA, Cole DJ, Grigore AM. Ventricular Assist Devices Today and Tomorrow. J Cardiothorac Vasc Anesth 2010; 24:656-80. [DOI: 10.1053/j.jvca.2009.11.011] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2009] [Indexed: 12/22/2022]
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27
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Nguyen DQ, Thourani VH. Third-Generation Continuous Flow Left Ventricular Assist Devices. INNOVATIONS-TECHNOLOGY AND TECHNIQUES IN CARDIOTHORACIC AND VASCULAR SURGERY 2010. [DOI: 10.1177/155698451000500402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Duc Q. Nguyen
- Division of Cardiothoracic Surgery, Joseph B. Whitehead Department of Surgery, Emory University School of Medicine, Atlanta, GA USA
| | - Vinod H. Thourani
- Division of Cardiothoracic Surgery, Joseph B. Whitehead Department of Surgery, Emory University School of Medicine, Atlanta, GA USA
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Oshima S, Sankai Y. Evaluation of optical propagation in blood for noninvasive detection of prethrombus blood condition. ASAIO J 2010; 55:550-5. [PMID: 19812478 DOI: 10.1097/mat.0b013e3181be2e44] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
This article evaluates the optical propagation to detect a "prethrombus" blood noninvasively. Thrombosis is still an inevitable issue in use of blood pumps, and it is required to predict thrombus formation as early as possible. We focused on the red blood cell (RBC) aggregation that is one of the features of thrombogenic process. First, by using a computer simulation, we calculated the optical propagations in blood for the RBC aggregation and nonaggregation blood. This simulation is based on the Monte-Carlo method and attempts to calculate the optical characteristics of the blood stochastically. In our simulation, the optical propagation with the RBC aggregation showed a different characteristic from that of the nonaggregation. Next, we examined the optical propagation in bovine blood with various activated whole blood clotting time (ACT). The blood mixed with sodium citrate was circulated by a blood pump. The ACT was adjusted between 1,000 and 50 seconds by controlling the ratio of calcium chloride solution to sodium citrate. We confirmed the RBC aggregation by using microscopic images and microthromboses in the pump directly. As a result, we evaluated that the change of the optical propagation has a correlation with thrombogenic process just as it was observed in our computer simulation. Our data indicate that the measurement of optical propagation can detect a prethrombous blood condition with RBC aggregation. Our study will help to establish optical technologies to detect prethrombous continuously and noninvasively.
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Affiliation(s)
- Shiori Oshima
- Cybernics Laboratory, Systems and Information Engineering, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8573, Japan.
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Griffith K, Jenkins E, Pagani FD. First American experience with the Terumo DuraHeart left ventricular assist system. Perfusion 2009; 24:83-9. [PMID: 19654148 DOI: 10.1177/0267659109106826] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Since the first implantation of a left ventricular assist system (LVAS) 45 years ago, LVAS therapy has emerged as a viable option for the treatment of advanced heart failure. The current generation of LVASs in clinical evaluation has design features enabling longer and more reliable support durations. We describe the operating characteristics of the DuraHeart LVAS (Terumo Heart, Inc., Ann Arbor, MI). The DuraHeart LVAS is a magnetically-levitated centrifugal pump that began a FDA-approved clinical trial for evaluation of bridge to transplant indication in July of 2008. Magnetic levitation of the spinning-pump impeller is hypothesized to improve long-term mechanical reliability and biological compatibility of the pump. Other design features make the DuraHeart LVAS particularly suited for implantation without cardiopulmonary bypass (CPB). A description of the implant procedure for the first six American implants of the DuraHeart LVAS both on-CPB and off-CPB, including CPB techniques employed, are discussed. While it is still very early in the DuraHeart LVAS experience, the initial outcomes of the first six patient implants would suggest that the device is a safe and effective LVAS.
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Affiliation(s)
- K Griffith
- University of Michigan Hospitals, Michigan 48109-5863, USA.
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Someya T, Kobayashi M, Waguri S, Ushiyama T, Nagaoka E, Hijikata W, Shinshi T, Arai H, Takatani S. Development of a Disposable Maglev Centrifugal Blood Pump Intended for One-Month Support in Bridge-to-Bridge Applications: In Vitro and Initial In Vivo Evaluation. Artif Organs 2009; 33:704-13. [DOI: 10.1111/j.1525-1594.2009.00900.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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33
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Yoshitake I, El-Banayosy A, Yoda M, Hata M, Sezai A, Niino T, Wakui S, Koerfer R, Minami K. First Clinical Application of the DuraHeart Centrifugal Ventricular Assist Device for a Japanese Patient. Artif Organs 2009; 33:763-6. [DOI: 10.1111/j.1525-1594.2009.00902.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sato K, Orihashi K, Kurosaki T, Tokumine A, Fukunaga S, Ninomiya S, Sueda T. Analysis of flow patterns in a ventricular assist device: a comparative study of particle image velocimetry and computational fluid dynamics. Artif Organs 2009; 33:352-9. [PMID: 19335412 DOI: 10.1111/j.1525-1594.2009.00726.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
In order to develop a diaphragm-type ventricular assist device (VAD), we studied the flow field change following structural modifications. We devised a center flow-type pump by putting a small projection on the center of the housing and/or diaphragm to provide a center in the flow field, and examined the following four types of VADs: N type without a projection, D type with a projection on the diaphragm, H type with a projection on the housing, and DH type with projections on both the diaphragm and housing. Computational fluid dynamics (CFD) was used for flow simulation. Particle image velocimetry (PIV) was also used to verify the reliability of the CFD method and to determine how the flow field changes in the presence of a projection. The results of the PIV and CFD analyses were comparable. The placement of a projection on the housing was most effective in rectifying the flow field.
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Affiliation(s)
- Katsutoshi Sato
- Department of Surgery, Division of Clinical Medical Sciences, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
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Sandner SE, Zimpfer D, Zrunek P, Rajek A, Schima H, Dunkler D, Grimm M, Wolner E, Wieselthaler GM. Renal function and outcome after continuous flow left ventricular assist device implantation. Ann Thorac Surg 2009; 87:1072-8. [PMID: 19324130 DOI: 10.1016/j.athoracsur.2009.01.022] [Citation(s) in RCA: 133] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2008] [Revised: 01/03/2009] [Accepted: 01/06/2009] [Indexed: 11/25/2022]
Abstract
BACKGROUND Renal dysfunction as a risk factor with the use of left ventricular assist devices (LVAD) is controversial. We determined the effect of renal function on outcomes after continuous flow LVAD implantation. METHODS Eighty-six patients with advanced heart failure undergoing continuous flow LVAD implantation as bridge to transplantation from November 1998 to July 2007 were retrospectively analyzed. Renal function was assessed using the Modification of Diet in Renal Disease study-derived glomerular filtration rates (GFR [mL x min(-1) x 1.73 m(-2)]). Patients were categorized into two groups based on pre-LVAD GFR: those with normal renal function (GFR > 60, n = 46), and those with renal dysfunction (GFR < 60, n = 40). RESULTS Post-LVAD survival at 1, 3, and 6 months for GFR greater than 60 was 91.3%, 79.9%, 72.6%, respectively, and for GFR less than 60, it was 92.5%, 66.5%, 47.9%, respectively (p = 0.038). Bridge-to-transplant rate was lower for GFR less than 60 than for GFR greater than 60 (40.0% versus 63.0%, p = 0.033). For GFR less than 60, GFR improved on LVAD support: implant to month 6, 41.7 +/- 11.5 to 62.7 +/- 25.0 (p = 0.021). Post-LVAD survival was improved in GFR less than 60 patients who after LVAD implantation recovered renal function to GFR greater than 60 (p < 0.001). Patients with post-LVAD renal failure had significantly lower post-LVAD survival regardless of pre-LVAD renal function (p < 0.001). CONCLUSIONS Patients with renal dysfunction have poorer outcomes after continuous flow LVAD implantation. However, renal function improves after LVAD implantation and is associated with improved survival. Our data underscore the importance of end-organ function in patient selection for LVAD therapy.
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Affiliation(s)
- Sigrid E Sandner
- Department of Cardiothoracic Surgery, Medical University of Vienna, Vienna, Austria.
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Sandner SE, Zimpfer D, Zrunek P, Rajek A, Schima H, Dunkler D, Zuckermann AO, Wieselthaler GM. Age and Outcome After Continuous-Flow Left Ventricular Assist Device Implantation as Bridge to Transplantation. J Heart Lung Transplant 2009; 28:367-72. [DOI: 10.1016/j.healun.2009.01.008] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2008] [Revised: 11/01/2008] [Accepted: 01/14/2009] [Indexed: 11/28/2022] Open
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Morshuis M, El-Banayosy A, Arusoglu L, Koerfer R, Hetzer R, Wieselthaler G, Pavie A, Nojiri C. European experience of DuraHeart magnetically levitated centrifugal left ventricular assist system. Eur J Cardiothorac Surg 2009; 35:1020-7; discussion 1027-8. [PMID: 19233673 DOI: 10.1016/j.ejcts.2008.12.033] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2008] [Revised: 12/14/2008] [Accepted: 12/16/2008] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The DuraHeart (Terumo Heart, Inc., Ann Arbor, Michigan, USA) is the world's first approved magnetically levitated centrifugal left ventricular assist system designed for long-term circulatory support. We report the clinical outcomes of 68 patients implanted with the DuraHeart as a bridge to cardiac transplantation in Europe. METHODS Sixty-eight patients with advanced heart failure (six females), who were eligible for cardiac transplantation were implanted with the DuraHeart between January 2004 and July 2008. Median age was 58 (range: 29-74) years with 31% over 65 years. Thirty-three of these patients received the device as a part of the European multi-center clinical trial. Survival analyses were conducted for 68 patients and other safety and performance data were analyzed based on 33 trial patients. RESULTS Mean support duration was 242+/-243 days (range: 19-1148, median: 161) with a cumulative duration of 45 years. Thirty-five patients (51%) remain ongoing, 18 transplanted, 1 explanted, and 14 died during support with a median time to death of 62 days. The Kaplan-Meier survival rate during support was 81% at 6 months and 77% at 1 year. Of the 13 patients (21%) supported for >1 year, 4 supported for >2 years, 1 supported >3 years, 2 transplanted, 2 died, and 9 ongoing with a mean duration of 744+/-216 days (range: 537-1148, median: 651). Major adverse events included driveline/pocket infection, stroke, bleeding, and right heart failure. There was no incidence of pump mechanical failure, pump thrombosis, or hemolysis. CONCLUSIONS The DuraHeart was able to provide safe and reliable long-term circulatory support with an improved survival and an acceptable adverse event rate in advanced heart failure patients who were eligible for transplantation.
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Affiliation(s)
- Michiel Morshuis
- Heart & Diabetes Center, North Rhine-Westphalia, Bad Oeynhausen, Germany
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Tsujimura S, Yamagishi H, Sankai Y. Development of data communication system with ultra high frequency radio wave for implantable artificial hearts. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2009; 2009:4110-4115. [PMID: 19964616 DOI: 10.1109/iembs.2009.5334021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
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.
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Affiliation(s)
- Shinichi Tsujimura
- Cybernics Laboratory, Systems and Information Engineering, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8573, Japan.
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Pagani FD. Continuous-Flow Rotary Left Ventricular Assist Devices with “3rd Generation” Design. Semin Thorac Cardiovasc Surg 2008; 20:255-63. [DOI: 10.1053/j.semtcvs.2008.08.002] [Citation(s) in RCA: 84] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2008] [Indexed: 11/11/2022]
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Wieselthaler GM, Schima H, Zimpfer D, Thoma H, Losert U. Forty years of development, experimental evaluation and clinical application of mechanical circulatory support at the Medical University of Vienna. Wien Klin Wochenschr 2008. [DOI: 10.1007/s00508-008-1043-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Esmore D, Kaye D, Spratt P, Larbalestier R, Ruygrok P, Tsui S, Meyers D, Fiane AE, Woodard J. A Prospective, Multicenter Trial of the VentrAssist Left Ventricular Assist Device for Bridge to Transplant: Safety and Efficacy. J Heart Lung Transplant 2008; 27:579-88. [DOI: 10.1016/j.healun.2008.02.012] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2007] [Revised: 02/08/2008] [Accepted: 02/17/2008] [Indexed: 10/22/2022] Open
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Sandner SE, Zimpfer D, Zrunek P, Dunkler D, Schima H, Rajek A, Grimm M, Wolner E, Wieselthaler GM. Renal Function After Implantation of Continuous Versus Pulsatile Flow Left Ventricular Assist Devices. J Heart Lung Transplant 2008; 27:469-73. [DOI: 10.1016/j.healun.2007.12.012] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2007] [Revised: 12/01/2007] [Accepted: 12/17/2007] [Indexed: 10/22/2022] Open
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Tsujimura S, Kuwabara T, Koguchi H, Yamane T, Tsutsui T, Sankai Y. Development of failure detection system based on vibration signal for smart artificial heart: in vitro study. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2008; 2008:697-702. [PMID: 19162751 DOI: 10.1109/iembs.2008.4649248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
To realize safe and effective medical treatment for patients with implantable artificial hearts, we have developed a smart artificial heart (SAH). The SAH can grasp the mechanical condition of the artificial heart and the physiological condition of the patient. The purpose of this study is to develop a failure detection system based on the vibration signal from artificial heart in order to enhance the ability of failure detection for the SAH. We suppose this vibration signal reflects not only the mechanical condition of the artificial heart but also a part of the physiological condition of the patient. The developed failure detection system is composed of a vibration sensor unit and a failure detection algorithm. The algorithm has a standard frequency pattern, which is made from the vibration signal of good condition of both the artificial heart and patient. Observing the difference from the standard frequency pattern, the algorithm detects failure conditions. Therefore, this algorithm does not need prior knowledge of vibration characteristics corresponding to failures. After confirming that the vibration signal are affected by pump speed and pulsation in two kinds of mock circulatory loops, we performed thrombogenesis detection by using the failure detection system in mock circulatory loop with sheep blood. As a result, this system indicated a possibility of detecting the initial sign of thrombogenesis earlier than current signal. In conclusion, we think that this failure detection system can cooperate with other sensor systems of the SAH and enhance the ability of failure detection for the SAH.
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Affiliation(s)
- Shinichi Tsujimura
- Systems and Information Engineering, University of Tsukuba, 1-1-1 Tennoudai, Ibaraki, 305-8573, Japan.
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