Slide deck on the AbioCor System presented by our student group for an introductory engineering course for biomedical and materials science engineering
The population of patients with end-stage heart failure has increased over the years, and the availability of donor organs has not be Sufficient.
End-stage heart failure represents a highly morbid condition for the patient with limited treatment options.
The treatment options are heart transplantation, heart–lung transplantation or implantation of a Mechanical Circulatory Support Devices.
If a patient waits until an organ becomes available for transplantation, they could need to wait months for that organ and therefore their condition could get worse.
There two Types of MCS Devices
1. Ventricular Assist Devices (VAD): are use on Short terms to Complement Failing Hearts.
2. Total Artificial Heart (TAH): one available option when long-term support of both ventricles is required.
The population of patients with end-stage heart failure has increased over the years, and the availability of donor organs has not be Sufficient.
End-stage heart failure represents a highly morbid condition for the patient with limited treatment options.
The treatment options are heart transplantation, heart–lung transplantation or implantation of a Mechanical Circulatory Support Devices.
If a patient waits until an organ becomes available for transplantation, they could need to wait months for that organ and therefore their condition could get worse.
There two Types of MCS Devices
1. Ventricular Assist Devices (VAD): are use on Short terms to Complement Failing Hearts.
2. Total Artificial Heart (TAH): one available option when long-term support of both ventricles is required.
This is a paper on the AbioCor Heart System written by our five-person student group during a semester-long introductory engineering course for materials science engineering. The paper includes a detailed description on under which medical conditions the use of this device is appropriate, a description of alternatives and predecessors to the AbioCor Heart System, the components that make up the AbioCor System, and a design recommendation for improving the AbioCor System. I wrote this paper with a group of other undergraduate engineering students for an introductory engineering class focusing on material use in biomedical devices.
Advanced Heart Failure Therapies: Cardiac Transplantation and Mechanical Circ...Allina Health
By Michael A. Samara, MD. A discussion about the growing population of patients with heart failure, advances in heart failure therapies, and the role of ECMO and LVAD implants in improving outcomes. "ECMO is an older therapy that is undergoing a renaissance. We've learned that poorer outcomes were a consequence of resorting to ECMO too late after multiple system failure. Now we're starting ECMO in the cath lab, even during active CPR."
This is a paper on the AbioCor Heart System written by our five-person student group during a semester-long introductory engineering course for materials science engineering. The paper includes a detailed description on under which medical conditions the use of this device is appropriate, a description of alternatives and predecessors to the AbioCor Heart System, the components that make up the AbioCor System, and a design recommendation for improving the AbioCor System. I wrote this paper with a group of other undergraduate engineering students for an introductory engineering class focusing on material use in biomedical devices.
Advanced Heart Failure Therapies: Cardiac Transplantation and Mechanical Circ...Allina Health
By Michael A. Samara, MD. A discussion about the growing population of patients with heart failure, advances in heart failure therapies, and the role of ECMO and LVAD implants in improving outcomes. "ECMO is an older therapy that is undergoing a renaissance. We've learned that poorer outcomes were a consequence of resorting to ECMO too late after multiple system failure. Now we're starting ECMO in the cath lab, even during active CPR."
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Artificial heart has provided a viable option for patient awaiting heart transplantation. Future developments on artificial hearts have the hope of eliminating the need for the transplantation completely.
This innovative heart implant concept, was not designed to extend the normal life cycle, but to transform the lives of thousands of patients whose only hope has been a transplantation.
A brief overview of defibrillator,its physical principles, types, its indications & contraindications and maintenance policy.this powerpoint is primarily intended for anaesthesiologists and other health care providers working in critical care centres.
EMGuideWire's Radiology Reading Room: Mechanical Circulatory Support DevicesSean M. Fox
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to Mechanical Circulatory Support Devices and is brought to you by Jenna Pallansch, MD, Morgan Penzler, MD, Gabriella Rivera Camacho, MD, Blaire Langa, NP, Claire Lawson, NP, Ashley Moore-Gibbs, DNP, Laszlo Littmann, MD, and Richard Musialowski, MD.
Write-up of final project for Multimedia Systems Design grad course. We implemented a content-based image search engine using color histograms, back projection, and Bhattacharyya distance.
Game-theoretic Patrol Strategies for Transit Systems: the TRUSTS System and i...Samantha Luber
Published at the International Conference on Autonomous Agents and Multiagent Systems (AAMAS 2013).
An expensive and prevalent problem worldwide, fare evasion in proof-of-payment transit systems introduces a need for randomized patrol strategies that effectively deter fare evasion and maximize transit system revenue. The Tactical Randomizations for Urban Security in Transit Systems (TRUSTS) approach addresses this challenge by using Bayesian Stackelberg games to model the transit patrolling problem and efficiently solving for the optimized patrol strategy for each patrol officer shift. In order to implement the TRUSTS approach in real-world transit systems, the METRO mobile app presented in this paper is being developed to work with TRUSTS to (i) provide officers with real-time TRUSTS-generated patrol schedules, (ii) provide recovery from unexpected schedule interruptions that can occur in real-world patrolling domains, and (iii) collect valuable patrol data for system analysis. An innovation in transit system patrolling technology, the METRO mobile app is an online agent that interacts with the user as an interface between the patrol officer and TRUSTS. In this paper, we propose a demonstration of the TRUSTS system, composed of the TRUSTS and METRO app components, focusing on the mobile app for user interaction. Providing a brief overview of the problem setting being addressed and the system components, this demonstration showcases how the TRUSTS system works and enables successful and robust deployment in the Los Angeles Metro System.
Demo video: http://www.youtube.com/embed/_lUG08ODqTI
Game-theoretic Patrol Strategies for Transit Systems (Slideshow deck)Samantha Luber
An expensive and prevalent problem worldwide, fare evasion in proof-of-payment transit systems introduces a need for randomized patrol strategies that effectively deter fare evasion and maximize transit system revenue. The Tactical Randomizations for Urban Security in Transit Systems (TRUSTS) approach addresses this challenge by using Bayesian Stackelberg games to model the transit patrolling problem and efficiently solving for the optimized patrol strategy for each patrol officer shift. In order to implement the TRUSTS approach in real-world transit systems, the METRO mobile app presented in this paper is being developed to work with TRUSTS to (i) provide officers with real-time TRUSTS-generated patrol schedules, (ii) provide recovery from unexpected schedule interruptions that can occur in real-world patrolling domains, and (iii) collect valuable patrol data for system analysis. An innovation in transit system patrolling technology, the METRO mobile app is an online agent that interacts with the user as an interface between the patrol officer and TRUSTS. In this paper, we propose a demonstration of the TRUSTS system, composed of the TRUSTS and METRO app components, focusing on the mobile app for user interaction. Providing a brief overview of the problem setting being addressed and the system components, this demonstration showcases how the TRUSTS system works and enables successful and robust deployment in the Los Angeles Metro System.
Presentation on our Autonomous Band project. The project consisted of a series of robotic arms playing xylophones. See the ful project writeup in my Slideshare documents.
Poster for our presentation on our Autonomous Robotic Arm that detects objects with an overhead camera, uses motion planning and reverse kinematics to retrieve objects, and places the objects in a bin. This project was done as part of the EECS 498 Autonomous Robotics Lab at the University of Michigan.
Poster for our presentation on our Web-controlled car project for EECS 373 at the University of Michigan. For our project, we soldered a FPGA board with an attached Wi-Fi chip to the remote of a remote-controlled toy car. The FPGA board opens a port and listens for control commands from a website. An on-board camera allows the web user to see from the car's perspective as he or she controls the car via the website.
Writeup for our Autonomous Band project. We created an artificial intelligence system that detects and parses large sheet music with an overhead camera and plays the music on xylophones with a series of synchronized robotics arms. See the website link on the writeup for video demonstrations and more information.
Presentation for our Digital Tuner Project at Technische Universität Berlin. We built the hardware for a music tuner board and programmed and tested the board to work as a guitar tuner board. See our project writeup for more specific details.
Research paper summarizing my work on artificial intelligence in issuing financial credit. Credit issuing strategies are simulated by trading agents in various credit networks.
A brief survey of approaches to using cognitive science artificial intelligence to achieve goals in both the cognitive science and artificial intelligence fields.
This is a brief research paper on artificial spinal disc implants that I wrote for an introductory engineering class that focused on material choice for biomedical implants
These are slides from a presentation given to provide an overview of our group research on artificial intelligence (specifically, artificially intelligence use to optimize strategy in game play).
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
1. AbiCor® Replacement Heart System Team Baits Adam Naylor, Philip Kaule, Samantha Luber, Andrew Foo, Scott Richards November 5 th , 2009
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4. Anatomy of the Heart http://www.starsandseas.com/SAS_Images/SAS_Physiol_Images/SAS%20cardiopics/heart_flow.jpg
5. Blood Flow Through the Heart Inferior Vena Cava Right Ventricle Right Atrium Superior Vena Cava Aorta Artery Pulmonary Artery Left Atrium Pulmonary Vein Left Ventricle http://www.starsandseas.com/SAS_Images/SAS_Physiol_Images/SAS%20cardiopics/heart_flow.jpg
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8. Timeline of Artificial Heart Development 1960 1970 1980 1990 2000 Pump Experimentation Liotta Total Artificial Heart Jarvik-7 Total Artificial Heart Jarvik 2000 Heart Akutsu III Total Artificial Heart AbioCor Replacement Heart System AbiorCor 2
14. External and internal tet Internal TET External TET http://faculty.ksu.edu.sa/MFALREZ/EBooks%20Library/Biomedical%20Technologies/AbioCor%20System-Impl.%20Art.%20Heart.pdf TET – Transcutaneous Energy Transmission
15. Battery System Internal battery - Used as a back-up system (45 minutes) PCE battery - Lasts for two hours (per battery pair) http://faculty.ksu.edu.sa/MFALREZ/EBooks%20Library/Biomedical%20Technologies/AbioCor%20System-Impl.%20Art.%20Heart.pdf
16. The Console Console http://faculty.ksu.edu.sa/MFALREZ/EBooks%20Library/Biomedical%20Technologies/AbioCor%20System-Impl.%20Art.%20Heart.pdf
17. PCE Control Module http://faculty.ksu.edu.sa/MFALREZ/EBooks%20Library/Biomedical%20Technologies/AbioCor%20System-Impl.%20Art.%20Heart.pdf
25. Materials used in the Thoracic Unit Velour Polyester cuffs are sutured onto the atria. Clear epoxy on the exterior blood pump area. Tri-leaflet valves are made of AngioFlex ®(Polyetherurethane) Exterior is covered in titanium
Picture of a diseased heart, what actually happens when the heart no longer functions. Why the things that go wrong cause heart failure Causes of heart failure: Coronary artery disease Heart attack High blood pressure Heart valve conditions Unhealthy lifestyle
Progression of artificial hearts over the past 50 years Pump experimentations – research started Bridges for transplantation Have been under development for 50 years Show improvement over time in: Weight/Size Length of patient sustainment Battery source efficiency/implementation Portability Safety
Second artificial heart to ever be implanted in humans (in 1981 by Dr. Denton A. Cooley) 3 parts: air-driven pumps, external monitoring/control system, external power system (AC/DC power) Replaces left and right ventricles (as opposed to Saxton and Andrews who simply connected ventricles to aorta with a tube/pump system) Used to sustain a man for 55 hours until a donor heart became available Continuous-flow pumps builds on Saxton and Andrew’s ideas of using continuous-flow pumps in humans Less than 3 day support (usually takes about a year to get a donor heart) Control system is the size of a large washing machine Complex external control system (required consistent monitoring) with switches and dials
Similar to AKUTSU III: Two air-powered pumps (artificial ventricles), external control system, external power system Air line connects Jarvik-7 to external consol for power/compressed air Tubing connects Jarvik-7 to aorta Supported a patient (William Schroeder) for 620 days Improved consol allows doctor to easily control/monitor pump rate, pumping pressure, and other essential functions Backup battery in case of power failure, also allows patient to be more easily transported External consol = size of refrigerator Doesn’t use air from lungs Doesn’t permanently replace heart Patient still must be hooked up to consol system for support Piercing connecting tubes increase risk of infections
Designed to address problems in akutsu II and jarvik 7. Advantages very quickly Too much stuff SPELL CHECK Shorten to: here’s what designers wanted: more portable, etc. still limited because: Compare more in part two of oral presentation Since it’s been implanted in 2001, it has been used in x cases, approved by gov. etc. Consists of internal and portable external components (to be described in detail) No connecting tubes that pierce skin (reduced risk of infection) Weighs only two pounds Portable external power source Internal control system and backup battery pack allows patient to be active Backup battery can sustain patient in case of external battery failure Heart replacement is permanent
The PCE and external TET are the two only exterior components of the AbioCor system
The PCE is designed to allow a patient mobility. It carries 2 pairs of batteries, PCE control module, and the external TET.
TET - Transcutaneous Energy Transmission - Is essentially a silicone ring containing a coil of wire. Power is transferred via electromagnetic induction to the implanted TET. a. Held in place by a DuoDERM® patch with Velcro® fasteners It is wireless so wires won’t have to be wired through the skin, this helps prevent infections.
Internal battery – placed in the abdomen. Sealed in a titanium case and is connected to the Implanted controller. It lasts for about a year and is easily replaced. External battery pack – 4 lbs
The AbioCor Console is a specialized computer with a keypad and screen. It is plugged into a regular household electrical wall outlet to provide power to the AbioCor System through the Implanted TET and External TETs. The Console also contains a backup Battery that can supply power for 35 to 40 minutes if normal electrical power is interrupted. The Console uses radio waves (like a cell phone) to send commands through the RF Antenna to the AbioCor Implanted Controller and to receive information from the Implanted Controller about how the Replacement Heart is functioning. The Console also notifies the patient and caregiver with alarm lights and sounds if a problem occurs with the AbioCor System. (KSA)
The control module, like the console, also monitors the status of all of the AbioCor System’s internal components by communicating with the implanted controller through wireless technology. If a problem occurs within one of the internal devices, the control module immediately notifies the patient. **Doctors cannot send commands using the PCE control unit. PCE control unit is a limited version of the console
• monitoring of the Thoracic Unit and the other implanted components • control of the Thoracic Unit • communication with the external components and alarms (the AbioCor Console or Patient-Carried Electronics) The Implanted Controller manages the cardiac output rate of the Replacement Heart to provide the needed blood flow. Most of the time, the Implanted Controller works automatically, but it can be operated manually by the clinician. The Implanted Controller is sealed in a titanium case, connected to the Replacement Heart by cables. It is implanted in the abdomen at the same time as the Replacement Heart. The Implanted Controller monitors the AbioCor system to make sure it is working correctly. It also exchanges information with the Console to trigger an alarm if a problem occurs. PCE – Only communication, PCE cannot give commands. Only console can give commands **cardiac output rate: the amount of blood that flows through your heart, expressed in liters per minute (L/min); a liter is about 34 ounces, a little more than a quart SEE KSU pg. 4
Clear Epoxy – Easily cast into irregular shapes and allows for visual inspections for proper blood flow. AngioFlex (Polyetherurethane) – Prevents backflow Hydraulic fluid - Interal
Anticoagulation – Drugs that prevent coagulation FDA instructions list over 20 do NOTS Including cleaners that contain: iodine, hydrogen peroxide, hypochlorite, permanganate, or chromate. (Will damage outer coverings)
Although the AbioCor System is an effective treatment for end stage heart failure, doctors use other biomedical systems as well to combat this disease. Depending on each individual patient’s condition, doctors may use Left Ventricle Assist Systems (LVAS) or a different artificial heart. Similar to artificial hearts, LVAS are also designed to provide cardiac support to the patient. Both LVAS and total artificial hearts are fully implanted in the body. However, unlike artifical hearts, LVAS do not replace the heart. Furthermore, LVAS supplement the native heart by optimizing blood flow output from the heart while total artifical hearts pump all of the patient’s blood (Hoenicke). Both devices are treatments of heart failure and end stage heart failure. Doctors select the appropriate biomedical system depending on the patient’s condition. Two of the most advanced LVAS are the Jarvik 2000 and the Penn State LionHeart™. The two most advanced and implanted artificial hearts are the AbioCor System and the CardioWest Heart.
Jarvik 2000 The Jarvik 2000 is a LVAS designed to sustain patients with heart failure for short-term periods or permanently. The device consists of three main parts: the internal axial flow pump, the external controller, and the battery. The internal axial flow pump is implanted inside the left ventricle of heart, where it uses a spinning rotor to propel blood from the left ventricle to the aorta (Jarvik 2000 FlowMaker). Meanwhile, the heart continues to pump naturally, pushing the extra volume of blood sent by the Jarvik 2000 to the rest of the body. Generating an average pump flow rate of 5 liters per minute, the internal axial pump of the Jarvik 2000 magnifies the blood output of the heart (Jarvik 2000 Heart). As seen in figure ??, the internal pump speed is connected to the external controller through a skin-piercing wire. The external controller is small and allows the patient to manually adjust blood flow rate of the internal pump depending on the patient’s activity level. This control unit also alerts the patient of any device malfunctions (Jarvik 2000 FlowMaker). Finally, the internal pump and external controller are both powered by the Jarvik 2000’s battery. A power cable connects the implanted pump to its wearable battery and controls through the abdominal wall (Jarvik 2000 FlowMaker). This external battery can power the Jarvik 2000 for 8 to 10 hours. The external components, including the external controller and the battery, weigh less than three pounds. Advantages and Disadvantages of the Jarvik 2000 In comparison to the AbioCor System, the Jarvik 2000 has three main advantages: a smaller and lighter internal component, a smaller and lighter external controller, and longer battery life. Because the Jarvik 2000 does not replace the heart, the device’s internal component is extrememly light, weighing only 85 grams, and small (Jarvik 2000 Heart). A smaller internal component allows doctors to use the Jarvik 2000 in more pateints, while the AbioCor System’s size limits its candidate patients. Furthermore, the Jarvik 2000’s smaller and lighter external controller and longer battery life makes patients more mobile and less restrained by their medical condition. On the other hand, the Jarvik 2000 does not replace the heart. In the event of an entirely failed heart, the Jarvik 2000 cannot be used as a treatment. The use of skin-piercing wires in the Jarvik 2000 is also a disadvantage because pierced skin increases the risk of infection. The AbioCor System, however, is completely self-contained and eliminates this risk.
Advantages: Smaller (1.5” by 2.5”) fits in small adults and children Ligheter (12 ounces, compared to the AbioCor which weights 2 lbs) Battery Life: Uses a 1lb external 14volt Lithium ion battery), lasts up to 10 hours (AbioCor lasts 2-3 hours) Disad: Not a TAH (helps ventricles pump blood optimally but does not pump blood for body, heart is not removed and replaced) Skin-piercing wires to connect internal components to external controller
Penn State LionHeart™ The Penn State LionHeart™ is the first fully self-contained LVAS, designed to sustain patients suffering from severe heart failure for both short-term and long-term periods. The LionHeart™ consists of internal components and external components. There are three internal components: the blood pump, motor controller, and internal coil. There are two external components: the battery pack and system monitor (Hoenicke). The LionHeart™ uses the same TET system as the AbioCor System to transfer power non-invasively through the intact skin to power the internal components. In fact, the LionHeart™ is essentially the LVAS equivalent of the AbioCor System. As seen in figure ??, the internal pump is implanted in the abdomen near the ribs. Advantages and Disadvantages of the Penn State LionHeart™ Because the Penn State LionHeart™ resembles the AbioCor System so much, the two biomedical devices share the same advantages and disadvantages. Both devices are relatively large in size and weigh nearly triple the size of a human heart, making both devices unsuitable for smaller patients. On the other hand, both devices are completely self-contained, eliminating the risk of life-threatening infections from skin-piercing wires in previous devices.
Two ventricles implanted separately that can move as needed to facilitate its implantation (vs. single-body large AbioCor) Limited by drive console size (smaller unite recently approved) Full FDA approval for bridge to transplant (vs. AbioCor implantation limited to two centers) CardioWest Heart The CardioWest Heart is an artificial heart that consists of two ventricles and an external driver and console system. These ventricles are implanted separately to replace diseased ventricles. The ventricles connect to the external driver through two skin-piercing tubes (one from each ventricle). The driver is pneumatic, providing pulses of air and vacuum to the ventricles that make the artifical heart pump (The CardioWest Total Artificial Heart). When a patient exercises and blood vessels contract, increased blood enters the artificial ventricles which in turn pumps more blood to meet the patient’s circulatory demand. The external driver system also serves as a console system, allowing the patient to adjust blood flow rate. Advantages and Disadvantages of the CardioWest Heart The CardioWest is smaller in size than the AbioCor System, allowing the CardioWest Heart to fit in more patients. Furthermore, the CardioWest heart uses two separate ventricles, making implantation surgery safer and easier (Singer, E.). However, unlike the AbioCor System, the CardioWest Heart is not desgiend to permanently replace the heart. The CardioWest also relies on skin-piercing tubes, which risks infection in the patient
The development of the AbioCor System and alternative biomedical systems simmilar to the AbioCor System is considered a huge accomplishment in biotechnology development and heart failure treatment. However, research on heart failure treatments and further development of artificial hearts continues. Doctors and engineers continue this research in hopes of further improving current systems and generating new treatments for heart failure. Two main areas of current research and devopment are the AbioCor II Replacement Heart System and tissue engineering.
Abiomed is currently developing a predecesor to the Abiocor System – the AbioCor II Replacement Heart System, designed to address many of the AbioCor System’s limitations. Although the AbioCor II is still in clinical testing, Abiomed plans to address the following problems of the AbioCor System in the AbioCor II System: the size and weight of the thoracic unit, blood clotting, and length of patient sustainment. The grapefruit-sized AbioCor System weighs about two pounds, making it too large to be implanted in the majority of patients. In fact, the AbioCor System is suitable to fit in only 50% of men and 20% of women (Singer, E.). In response to this problem, the AbioCor II System will be 30% smaller than its predecesor, fitting in the majority of men and at least 50% of women (Smith, A.), . The AbioCor System also has caused incidents of blood clot formation in several patients. As a result, Abiomed is investigating new polymers and biosynthetic materials for the AbioCor II to decrease the likelihood of clot formation in patients (Singer, E.). Finally, the AbioCor System is designed to sustain patients for up to 18 months. The AbioCor II is designed to last 5 years.
Along with further artificial heart development, doctors are experimenting with tissue engineering as an alternative solution to heart failure with the ultimate goal of regrowing a failed heart. One popular idea is the use of nanotechnology to create hundreds of microsized electromagnetic motors to replace a failing heart. This unit would be powered by a TET system simmilar to that of the AbioCor (Singer, E.). Furthermore, a team of doctors at MIT is experimenting with a biodegradable scaffold that can be used to guide the orientation of culture heart cells; ideally, the heart cells will be orientated into a new heart (Thomson). Although tissue engineerign research is still in preliminary phases, the ability to regrow failed hearts would be an effective and long-term solution to heart failure if plausible.
The AbioCor is about the size of a grapefruit or softball. The natural heart is about the size of a clenched fist. As such, only 50 percent of men and 20 percent of women have chest cavities large to hold the AbioCor (http://www.chfpatients.com/implants/artificial_hearts.htm). We recommend that the AbioCor is trimmed down to accommodate smaller patients. Titanium has a density around 4.5 g per cubic centimeter. The densities of polymers and organic tissue are significantly lower at around 1-2 g per cubic centimeter. We suggest that titanium be replaced with biomaterials. For example, The Polymer Technology Group, Inc., a specialized biomaterial research and development company, has created several synthetic polymers, including BioSpan Segmented Polyurethane and Bionate Thermoplastic Polycarbonate Urethane. Other companies are hard at work engineering tissue for use in a biomedical application. If AbioMed were to replace titanium with biomaterials, not only would the thoracic unit weigh less and take up less space, but it would have the added bonus of increased biocompatibility (titanium is not perfectly biocompatible).
The batteries, as previously mentioned, only last for about 4 hours on a charge. The internal battery can only sustain the System for 45 minutes before it runs out of charge. The battery system, as it stands, hinders the freedom of the patient tremendously. We recommend that the AbioCor takes advantage of cutting edge battery technology in order to give patients more freedom.
The AbioCor is an extremely complicated system and obviously an extremely important one. It is imperative that the System is carefully monitored at all times. Although this is the PCE’s job, we recommend that an additional monitoring system be put in place. No matter how advanced the PCE’s software is, there will be glitches. In the case of the AbioCor, glitches could very well result in death. We are envisioning a situation where data are constantly collected on the System and sent to expert technicians who make sure the system is operating correctly.