Sensorless measurement of biological information in a magnetically levitated artificial heart and its application to QOL improvement technology

Impact ◽  
2019 ◽  
Vol 2019 (10) ◽  
pp. 70-72
Author(s):  
Wataru Hijikata

Heart disease is the leading cause of death in men and women around the world and it is a significant problem that requires remedy. Heart failure is where the heart is not pumping blood around the body as effectively as it should. Importantly, heart failure does not mean that the heart has stopped working, but it does require support in order to get it working better. Over the past few decades, there have been many innovations to help address the problems with heart failure, including developing ventricular assist devices (VADs). A VAD is a mechanical pump that is placed inside the body to support heart function and blood flow in heart patients. It works by taking blood from a lower chamber in the heart and pumping it to the body and vital organs, in the same way that a healthy heart would. Dr Wataru Hijikata is an expert in mechanical engineering and technology with a focus on healthcare outcomes. He explains that the first generation of VADs was a pulsatile flow type, but because of the complicated mechanical structure, the size of them was large and they had low durability. He notes that the second generation VAD was a continuous flow type. Because the blood flow was generated by the rotation of an impeller, the mechanical structure was simple and the size was small. However, the bearings to support the rotating impeller led to low durability. 'Third generation VADs are continuous flow types with contactless support of the impeller by magnetic bearing or hydrodynamic bearings,' Hijikata outlines. Owing to the contactless support technology, the durability of VADs has been enhanced and the size of the device is small. 'However, while there has been significant progress over the years, VADs are still far from perfect and there is much room for improvement,' he concludes. With that in mind, a team of researchers based at the Department of Mechanical Engineering in the Tokyo Institute of Technology, Japan, is investigating a means of improving VADs.

Angiology ◽  
2020 ◽  
Vol 72 (1) ◽  
pp. 9-15
Author(s):  
Pavel Poredos ◽  
Mateja K. Jezovnik ◽  
Rajko Radovancevic ◽  
Igor D. Gregoric

The endothelium plays a crucial role in maintaining cardiovascular homeostasis. Shear stress generated by flowing blood regulates the release of substances that provide adequate tissue perfusion. The extent of damage to endothelial cells depends on locally disturbed shear stress caused by the deteriorated flow. Patients with heart failure have reduced cardiac output, which results in reduced blood flow and negative shear stress. Reduced shear stress also affects microcirculation and reduces tissue perfusion. Consequently, the production of free oxygen radicals is increased and bioavailability of nitric oxide is additionally decreased. Therefore, endothelial dysfunction is involved in the progression of heart failure and cardiovascular events. Left ventricular assist devices (LVAD) are used for the treatment of patients with advanced heart failure. Older pulsatile flow LVADs were mostly substituted by continuous-flow LVADs (cf-LVADs). Despite the advantages of the cf-LVADs, the loss of pulsatility leads to different complications on the micro- and macrovascular levels. One of the pathogenetic mechanisms of cardiovascular complications with cf-LVADs may be endothelial dysfunction, which after the implantation of the device does not improve and may even deteriorate. In contrast, the pulsatile pattern of LVADs on blood flow could preserve endothelial function.


Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Salpy V Pamboukian ◽  
Roberta C Bogaev ◽  
Stuart D Russell ◽  
Andrew J Boyle ◽  
Nader Moazami ◽  
...  

Small continuous flow left ventricular assist devices (LVAD) are providing new options for women in advanced heart failure who due to body size limitations were historically excluded from use of large first generation pulsatile devices. We report the experience of women one year after implantation with the new, HeartMate II continuous flow LVAD for bridge to transplantation. Patients (n=279), 24% female (F), 76% male (M) in NYHA Class IV heart failure, LV ejection fraction 16±7% (F), 16±6% (M), mostly inotrope dependent and about half on intraaortic balloon pump support (50% F, 43% M), who had been enrolled in the HM II clinical trial for at least 1 year as a bridge to cardiac transplantation at 33 centers were analyzed. Outcomes and causes of death in the first year of support between F and M recipients were determined. The percentage of patients who had undergone transplantation, recovery of the heart with device removal, or continued on HM II support after one year were the same (80%) between M and F. However, the percentage of patients who had received a heart transplant was significantly less for F (38%) than M (53%) (p<0.05). Median duration of support for F was 226 days (range 8–1004) vs. 143 days (range 0–1057) for M. Mortality on device support was 20% for F and 18% M. There were no statistically significant differences in leading causes of death: sepsis (1.5% F vs 4.2% M), ischemic stroke (3.1% F vs 1.9% M), hemorrhagic stroke (3.1% F vs 1.4% M), and right heart failure (3.1% F vs 1.9% M). Of 82 patients continuing on support at 1 year, 26 (32%) were F with median BSA of 1.65 vs 2.14 m 2 for M. Kaplan Meier survival at one year was similar for females (74%) and males (76%). The smaller, more durable HM II rotary LVAD may be especially advantageous to women with advanced HF as a bridge to cardiac transplantation, because of significantly smaller BSA and need for extended duration of mechanical support due to longer wait times for suitable organ donors. Outcomes at one-year


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