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Erik SimpanenSeptember 27th , 2011BME 281
Heart Disease A generic term for referring to numerous different
forms of sicknesses that effect the heart Causes more than one million deaths a year (4) Transplants were originally thought the only
solution A heart replacement has been a scientology goal
on everybody’s mind for some time.
Then and Now:
First: Transplants were originally thought to be the only answer
Then: Pumps were only meant to replace the heart for a small period of time before a donor heart was found
Now: Implant an artificial heart into patients for extended periods of time before a donor is found
Goal: To eventually engineer a heart that can be permanently left inside the body
The first successful heart-lung machine
Dr. John Gibbon during an open heart surgery in 1953,
The first artificial heart
First developed by a team of physicians, engineers and students who improved on an original design by Dr. Kolff,
This artificial heart, called the Jarvik-7, was named after one of the project managers, Robert Jarvik.
First put into a human in 1982
Survived 112 days connected to the 400 pound machine attached to the heart.
History:
Disadvantages:
Many disadvantages to the first continuous blood flow pumps including:
Damage to the blood cells because of the stress the pump was putting on the blood
Energy required to keep pumping. (2)
Versions of Artificial Hearts:
Jarvik-7
One of the first designs with the two ventricles attached to anatomical connections (5)
Rotary Artificial Heart (1)
a miniaturized rotary artificial heart that was implanted into the natural heart
Types Continued:
Vibrating Flow Pump
Thought to be less destructive to the blood cells
CardioWest TAH-t (or temporary total artificial heart)
approved by the FDA in 2004
more than 888 patients have been treated with this artificial heart
Much smaller than previous models
160 grams and 400ml
able to increase and decrease beats per minute based on the activities the patient is performing at the time (6)
Artificial Heart Design
Air is pumped through the diaphragms to create the blood flow
Made of polyurethane
Two round ventricles Anatomical connections
to the major blood vessels and the atria
Hard outer housing to protect the interior, which contains a number of different diaphragms.
1 holds the blood 2 intermediate
diaphragms 1 air diaphragm.
Tubes leading out of the heart made from polyurethane
Velour skin buttons internal tubes
connected to the heart driver system.
Drivers: a source of compressed
air, a vacuum, and electricity that
powers and controls the artificial heart
plugged in or powered by rechargeable batteries
frequency and pressure is different in each ventricle
Artificial Heart Drivers: (Cont.)
a primary pneumatic driver
a backup pneumatic driver
an alarm and computer system for controlling the artificial heart
batteries air tanks anatomical connection
to the artificial heart inside the body.
Portability
Drastic change in the size of the drivers
Before: more than 400
pounds patients not
allowed to leave Nowadays:
Portable Leave the hospital Originally
developed in Europe
2001 AbioCore powered by a
hydraulic pump a wireless
charging system and an external
battery pack all worn in a belt
around the waist.
Most Recently:
Complications
Originally, many complications
Now, Strokes 10% of patients
received a stroke during the surgery
Only 2% of patients suffered a stroke during device support
Questions…
Citations:
1.) Inventor: Robert Jarvik, Artificial Hearts With Permanent Magnet Bearings, U.S. Patent, 1996
2.) Don B. Olsen, The History of Continuous-Blood Flow Pumps, Artificial Organs, Volume 24, Issue 6, pp. 401
3.) Joyce, Response of the Human Body to the First Permanent Implant of the Jarvik-7 Total Artificial Heart, Transactions-American Society for Artificial Internal Organs, Volume 29, pp.81, 1983
4.) Devries, Clinical Use of the Total Artificial Heart, The New England Journal of Medicine, (Articial) 1984
5.) Wang, Component Engineering for an Implantable System, Artificial Organs, Volume 28, pp. 869-873, 2004
6.) Copeland, Out-Of-Hospital Total Artificial Heart Patients, Texas Heart Institute Journal, Volume 37, pp. 654-655, December, 15 2010
Citations:
DeVries, The New England Journal of Medicine, “Clinical Use of the Total Artificial Heart”, February 2, 1984, (http://www.nejm.org/doi/pdf/10.1056/NEJM198402023100501)
DeVries, The Permenant Artificial Heart, The Journal of American Medical Association, 2000 (http://jama.ama-assn.org/content/259/6/849.short)
El-Banayosy, “CardioWest Total Artificial Heart”, The Annals of Thoracic Surgery, July 21, 2005 (http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T11-4GP19JK-17&_user=657938&_coverDate=08%2F31%2F2005&_rdoc=1&_fmt=high&_orig=gateway&_origin=gateway&_sort=d&_docanchor=&view=c&_searchStrId=1726932657&_rerunOrigin=scholar.google&_acct=C000035679&_version=1&_urlVersion=0&_userid=657938&md5=45c46c94c67cecaf539efe125365b55f&searchtype=a)
Copeland, The New England Journal of Medicine, “Cardiac Replacement…”, Volume 351, No. 9, August 26th, 2004 (http://www.nejm.org/doi/pdf/10.1056/NEJMoa040186)
Noman, Artificial Heart, January 4, 2011