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Advanced Therapeutic Options in Acute Heart Failure
Published in Andreas P. Kalogeropoulos, Hal A. Skopicki, Javed Butler, Heart Failure, 2023
Tiffany Dong, Aditi Nayak, Alanna Morris
For those who require biventricular support, a TAH may be a long-term bridge option. Placement requires a body surface area of 1.7–2.5 m2 or >10 cm between the 10th thoracic vertebra and the sternum. With TAH, the work of the native ventricles and valves is replaced by a pneumatically powered artificial heart. Complications include stroke, bleeding, thrombosis, and infections, e.g., mediastinitis. TAH has been associated with renal failure due to BNP withdrawal.38 Anemia in TAH recipients is multifactorial, with etiologies including hemolysis, inflammation, and decreased erythropoiesis.39 A study comparing an implantable biventricular assist device with TAH reported that TAH had lower stroke rates with better 90-day survival.40 TAH also improved survival to cardiac transplant and post-transplant survival.41 Durable devices are discussed in more detail in Chapter 18.
Medical and Biological Applications of Low Energy Accelerators
Published in Vlado Valković, Low Energy Particle Accelerator-Based Technologies and Their Applications, 2022
In the case of artificial heart valves, there is an urgent need for developing alternative heart valves to overcome long-term stability and biocompatibility issues that are associated with artificial heart valves. The main challenge faced by material engineers is to create new, self-healing materials that can offer adequate mechanical properties for highly dynamic biological environments. While various self-healing materials have been developed, none so far has been used for the fabrication of heart valves.
Living Donors, Non-Human Sources, and Cadaveric Donors
Published in David Lamb, Organ Transplants and Ethics, 2020
The idea of a totally implantable artificial heart was first mooted in 1964, when the USA National Heart Institute drew up a plan for the construction of a prototype and obtained financial support from Congress for the project. The researchers were unrealistically optimistic for they looked forward to the mass production and implantation of artificial hearts by 1970 (Varga, 1984:236). Despite some limited success with animals, artificial implants into humans did not achieve any significant results. One major problem is the high incidence of strokes and chronic infections, which has not been overcome. The first human implantation of an artificial heart was performed in Texas in 1969 on a dying patient, Haskelle Karp, who survived for a further 65 hours with it before receiving a human heart. He died shortly after. In 1977 a woman in Zurich survived for two days with an artificial heart (ibid:23-7). The initial belief that an artificial heart might function as a permanent replacement has given way to more realistic therapy. Artificial hearts are presently used, in a limited sense, as ‘bridges’ to assist survival until a donor becomes available. As of January 1987, some 17 US transplant centres were using artificial heart ‘bridges’, and 63 patients had been implanted with such a device (New York Task Force, 1988:18). The number of artificial hearts and ventricular assistance devices currently functioning as bridges is 200 world-wide (Gil, 1989:24).
Exercise training with cycle ergometry in the intensive care unit after total artificial heart implantation
Published in Baylor University Medical Center Proceedings, 2020
Katelyn D. Brown, Jenny Adams, Dan M. Meyer
The total artificial heart (TAH) is a pneumatic, pulsatile pump system used for patients with severe biventricular heart failure, at imminent risk of death, as a salvage therapy for bridge to transplant.1–4 Postoperatively, patients who receive a TAH can experience loss of strength and impaired functional capacity due to prolonged hospitalization and bedrest.5 Since increased postoperative activity is associated with more desirable postoperative outcomes,5–7 it is essential to provide patient-specific methods for increasing activity in high-risk patients. Here we describe exercise progression involving a six-session, symptom-limited, cycle ergometer training program based on hemodynamics, patient symptoms, and device manufacturer guidelines for a patient in the cardiovascular intensive care unit who had just received a TAH.
Minimally invasive left ventricular assist device implantation: optimizing device design for this approach
Published in Expert Review of Medical Devices, 2020
Anamika Chatterjee, Silvia Mariani, Jasmin S. Hanke, Tong Li, Ali Saad Merzah, Regina Wendl, Axel Haverich, Jan D. Schmitto, Günes Dogan
The treatment of pulmonary embolism with the support of cardiopulmonary bypass (CPB) by Gibbon et al. in 1953 was one of the first works to highlight the potential of cardiac pumping function support by mechanical devices, triggering subsequent innovations in MCS devices and ushering in a modern era of MCS [12]. The feasibility of a pneumatically driven total artificial heart (TAH) implantation was first demonstrated in a canine model in 1958 and an artificial ventricle was implanted for the first time in humans by Liotta et al. in 1963 [12]. Following the first cardiac transplantation procedure by Barnard in 1967, Cooley et al. performed TAH implantation as a mechanical BTT in 1969 [12]. This was followed by LVAD implantation as a BTT by Norman et al. in 1978 [12]. In 1984 DeVries et al. implanted the TAH for permanent cardiac support, allowing the patient to survive for 112 days [12].
Longitudinal data analysis in the presence of informative sampling: weighted distribution or joint modelling
Published in Journal of Applied Statistics, 2019
Zahra Sadat Meshkani Farahani, Esmaile Khorram, Mojtaba Ganjali, Taban Baghfalaki
The second real dataset is taken from Lim et al. [10]. It concerns follow-up of patients who underwent surgery to implant artificial heart valves. The n=256 subjects were followed-up during a 3-year period to measure various predictors and outcome variables. One of the measured outcome variables, which is studied here, is the left-ventricular-mass-index (LVMI). The predictors of sex (male and female), preoperative left ventricular ejection fraction (LV) (categorised as good, moderate impairment and severe impairment), and size of the valve are considered as well. Unlike the predictors, the outcome variable is not observed completely in all 3 time points. There are