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Mechanical assist device

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https://www.readbyqxmd.com/read/28212401/preload-based-starling-like-control-of-rotary-blood-pumps-an-in-vitro-evaluation
#1
Mahdi Mansouri, Shaun D Gregory, Robert F Salamonsen, Nigel H Lovell, Michael C Stevens, Jo P Pauls, Rini Akmeliawati, Einly Lim
Due to a shortage of donor hearts, rotary left ventricular assist devices (LVADs) are used to provide mechanical circulatory support. To address the preload insensitivity of the constant speed controller (CSC) used in conventional LVADs, we developed a preload-based Starling-like controller (SLC). The SLC emulates the Starling law of the heart to maintain mean pump flow ([Formula: see text]) with respect to mean left ventricular end diastolic pressure (PLVEDm) as the feedback signal. The SLC and CSC were compared using a mock circulation loop to assess their capacity to increase cardiac output during mild exercise while avoiding ventricular suction (marked by a negative PLVEDm) and maintaining circulatory stability during blood loss and severe reductions in left ventricular contractility (LVC)...
2017: PloS One
https://www.readbyqxmd.com/read/28210321/telemedicine-in-chronic-obstructive-pulmonary-disease
#2
Nicolino Ambrosino, Guido Vagheggini, Stefano Mazzoleni, Michele Vitacca
: Telemedicine is a medical application of advanced technology to disease management. This modality may provide benefits also to patients with chronic obstructive pulmonary disease (COPD). Different devices and systems are used. The legal problems associated with telemedicine are still controversial. Economic advantages for healthcare systems, though potentially high, are still poorly investigated. A European Respiratory Society Task Force has defined indications, follow-up, equipment, facilities, legal and economic issues of tele-monitoring of COPD patients including those undergoing home mechanical ventilation...
December 2016: Breathe
https://www.readbyqxmd.com/read/28209402/chemokine-receptor-patterns-and-right-heart-failure-in-mechanical-circulatory-support
#3
Aditi Nayak, Colin Neill, Robert L Kormos, Luigi Lagazzi, Indrani Halder, Charles McTiernan, Jennifer Larsen, Ana Inashvili, Jeffrey Teuteberg, Timothy N Bachman, Karen Hanley-Yanez, Dennis M McNamara, Marc A Simon
BACKGROUND: Right ventricular failure (RVF) complicates 9% to 44% of left ventricular assist device (LVAD) implants post-operatively. Current prediction scores perform only modestly in validation studies, and do not include immune markers. Chemokines are inflammatory signaling molecules with a fundamental role in cardiac physiology and stress adaptation. In this study we investigated chemokine receptor regulation in LVAD recipients who develop RVF. METHODS: Expression of chemokine receptor (CCR) genes 3 to 8 were examined in the peripheral blood of 111 LVAD patients, collected 24 hours before implant...
December 23, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28208117/percutaneous-transcatheter-therapies-for-the-management-of-left-ventricular-assist-device-complications
#4
Rohan J Kalathiya, Jonathan Grinstein, Nir Uriel, Atman P Shah
Heart failure is a growing epidemic in the United States and throughout the world. The utilization of continuous-flow left ventricular assist devices (LVADs) has greatly increased over the last decade. In addition, a limited supply of organ donors has led to a rise in the use, and duration, of LVADs for destination therapy. The increased use of LVAD therapy has led to the observation of mechanical complications such as device thrombosis, de novo aortic insufficiency, and outflow graft stenosis, all of which are associated with prolonged LVAD support...
February 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28195883/long-term-pediatric-ventricular-assist-device-therapy-a-case-report-of-2100-days-of-support
#5
Neha J Purkey, Aileen Lin, Jenna M Murray, Maryalice Gowen, Paul Shuttleworth, Katsuhide Maeda, Christopher S Almond, David N Rosenthal, Sharon Chen
Ventricular assist devices (VADs) have been placed as destination therapy in adults for over twenty years but have only recently been considered an option in a subset of pediatric patients. A 2016 report from the Pediatric Interagency Registry for Mechanical Circulatory Support (PediMACS) revealed only eight pediatric patients implanted as destination therapy. We report the case of an adolescent male with Becker Muscular Dystrophy (BMD) who underwent VAD placement in 2011 as bridge to candidacy. He subsequently decided to remain as destination therapy and so far has accrued over 2100 days on VAD support, the longest duration of pediatric VAD support reported in the literature to date...
February 9, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28187319/quantitative-diagnosis-of-breast-tumors-by-characterization-of-viscoelastic-behavior-of-healthy-breast-tissue
#6
N Madani, A Mojra
The main objective of the present study is to propose a model for characterizing the viscoelastic behavior of the healthy breast tissue. The study population consisted of 60 healthy regions of the breast tissue belonged to 9 female cases. To accomplish this, the attending cases were examined by a robot-assisted device and the mechanical stress resulted from an applied compressive strain was measured. Correlation between the experimental stress and the strain data identifies the breast tissue mechanical behavior...
February 3, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28179009/benefits-of-ultra-fast-track-anesthesia-in-left-ventricular-assist-device-implantation-a-retrospective-propensity-score-matched-cohort-study-of-a-four-year-single-center-experience
#7
Rashad Zayat, Ares K Menon, Andreas Goetzenich, Gereon Schaelte, Ruediger Autschbach, Christian Stoppe, Tim-Philipp Simon, Lachmandath Tewarie, Ajay Moza
BACKGROUND: The use of left ventricular assist devices (LVADs) has gained significant importance for treatment of end-stage heart failure. Fast-track procedures are well established in cardiac surgery, whereas knowledge of their benefits after LVAD implantation is sparse. We hypothesized that ultra-fast-track anesthesia (UFTA) with in-theater extubation or at a maximum of 4 h. after surgery is feasible in Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) level 3 and 4 patients and might prevent postoperative complications...
February 8, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28164163/change-of-sagittal-spinal-alignment-and-its-association-with-pain-and-function-after-lumbar-surgery-augmented-with-an-interspinous-implant
#8
Rebecca J Crawford, Quentin J Malone, Roger I Price
BACKGROUND: Interspinous spacer/implants like the Device for Intervertebral Assisted Motion (DIAM™) are controversially yet commonly used in the surgical treatment of lumbar degenerative pathologies. Criticism is based on ill-defined indications, lack of superiority over decompression, and a poorly understood mechanical effect. Yet, continued use by surgeons implies their perceived clinical merit. We examined radiographic spinal alignment for 12 months, and pain and function for 24 months, after DIAM-augmented surgery to improve the understanding of the mechanical effect relating to clinical outcomes in patients...
2017: Scoliosis and Spinal Disorders
https://www.readbyqxmd.com/read/28163432/early-primary-graft-failure-after-a-pediatric-heart-transplant-and-successful-rescue-with-plasmapheresis-immunoglobulins-and-alemtuzumab
#9
Shashi Raj, Phillip Ruiz, Paolo Rusconi
Early primary graft failure after pediatric orthotopic heart transplantation (OHT) has a high mortality rate and can occur due to several causes including but not limited to prolonged graft ischemia time, suboptimal preimplant myocardial preservation, hyperacute rejection, and maladaptation of the graft to the host's hemodynamic status. Mechanical circulatory support with either extracorporeal membrane oxygenation (ECMO) or ventricular assist device has been used for the rescue of primary graft failure in pediatric patients after heart transplant...
January 2017: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/28161770/posterior-ventricular-restoration-treatment-for-heart-failure-a-review-past-present-and-future-aspects
#10
REVIEW
Tadashi Isomura, Yasuhisa Fukada, Takuya Miyazaki, Minoru Yoshida, Akimasa Morisaki, Masahiro Endo
Congestive heart failure (CHF) is one of the major causes of death and occurs in more than 15,000,000 patients worldwide. The incidence is expected to increase in parallel with the aging population. Most current therapies for CHF are medications, and biventricular pacing implantation as appropriated by cardiologists, or surgical interventions. The heart transplantation for indicated patients is still gold standard surgery although the 10-year survival rate is approximately 60% based on the worldwide data. However, the cardiac transplantation remains epidemiologically insignificant because of donor pool limitations...
February 4, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28160976/global-outcome-in-patients-with-left-ventricular-assist-devices
#11
Timothy J Fendler, Michael E Nassif, Kevin F Kennedy, Susan M Joseph, Scott C Silvestry, Gregory A Ewald, Shane J LaRue, Justin M Vader, John A Spertus, Suzanne V Arnold
Left ventricular assist devices (LVADs) improve survival and quality of life (QOL) for most, but not all, patients with advanced heart failure. We described a broader definition of poor outcomes after LVAD, using a novel composite of death, QOL, and other major adverse events. We evaluated the frequency of poor global outcome at 1 year after LVAD among 164 patients (86% Interagency Registry for Mechanically Assisted Circulatory Support profile 1 to 2; shock or declining despite inotropes) at a high-volume center...
January 5, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28159376/the-role-of-durable-left-ventricular-assist-devices-in-advanced-heart-failure-would-my-patient-benefit
#12
Natasha Aleksova, Sharon Chih
Mechanical circulatory support improves survival and quality of life in selected patients with advanced heart failure. The Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) clinical profile (profiles 1-7) is a classification system of patients with American Heart Association stage D and New York Heart Association functional class IIIb-IV heart failure. Most left ventricular assist devices (LVADs) are implanted in patients dependent on inotropes (INTERMACS 3) or whose condition is deteriorating with inotropic support (INTERMACS 2)...
November 29, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28155672/the-study-on-hemodynamic-effect-of-series-type-lvad-on-aortic-blood-flow-pattern-a-primary-numerical-study
#13
Qi Zhang, Bin Gao, Yu Chang
BACKGROUND: Left ventricular assist device (LVAD) has become an alternative treatment for end-stage heart failure patients. Series type of LVAD, as a novel LVAD, has attracted more and more attention. The hemodynamic effects of series type LVAD on aortic blood pattern are considered as its important characteristics; however, the precise mechanism of it is still unclear. METHODS: To clarify the hemodynamic effects of series type LVAD on aortic blood flow pattern, a comparative study on the aortic blood flow pattern and hemodynamic states were carried out numerically for two cases, including series type LVAD support and normal condition...
December 28, 2016: Biomedical Engineering Online
https://www.readbyqxmd.com/read/28154973/progression-of-postural-changes-in-parkinson-s-disease-quantitative-assessment
#14
Alexander Khlebtovsky, Ruth Djaldetti, Yaniv Rodity, Ofir Keret, Gloria Tsvetov, Ilana Slutzcki-Shraga, Felix Benninger
Previous studies of posture in Parkinson's disease (PD) patients focused on the pathophysiology of severe deformities, using mainly subjective estimations or goniometric measures. The aim of this study was to investigate risk factors associated with flexed posture in PD and their effects on the course of posture variations. One hundred-ninety patients with definite PD were prospectively evaluated for angles of spinal inclination in upright position, extension, and flexion using a mechanical computer-assisted, hand-held device (SpinalMouse)...
February 2, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28153356/mechanical-circulatory-support-for-end-stage-heart-failure
#15
Alain Combes
Mechanical circulatory assistance has become a frequent therapeutic option for patients with advanced heart failure. For patients with acute cardiogenic shock and impaired organ function, short-term assistance with venoarterial extracorporeal membrane oxygenation is the leading therapeutic option. It enables a "bridge to decision-making" i.e. withdrawal of the device after myocardial recovery or after recognition of therapeutic futility, or as a bridge-to-transplantation or to long-term mechanical support. For Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) class 2-6 patients, implantation of a long-term ventricular assist-device (VAD) should be considered before progression to multiple organ failure if heart transplantation is not a first-line option...
January 11, 2017: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/28146651/intrapericardial-left-ventricular-assist-device-for-advanced-heart-failure
#16
RANDOMIZED CONTROLLED TRIAL
Joseph G Rogers, Francis D Pagani, Antone J Tatooles, Geetha Bhat, Mark S Slaughter, Emma J Birks, Steven W Boyce, Samer S Najjar, Valluvan Jeevanandam, Allen S Anderson, Igor D Gregoric, Hari Mallidi, Katrin Leadley, Keith D Aaronson, O H Frazier, Carmelo A Milano
Background Mechanical circulatory support with a left ventricular assist device (LVAD) is an established treatment for patients with advanced heart failure. We compared a newer LVAD design (a small intrapericardial centrifugal-flow device) against existing technology (a commercially available axial-flow device) in patients with advanced heart failure who were ineligible for heart transplantation. Methods We conducted a multicenter randomized trial involving 446 patients who were assigned, in a 2:1 ratio, to the study (centrifugal-flow) device or the control (axial-flow) device...
2, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28146628/enhanced-self-assembly-of-crystalline-large-area-and-periodicity-tunable-tio2-nanotube-arrays-on-various-substrates
#17
Xiaoguang Liang, Heng Zhang, Ho-Wa Li, Lei Shu, HoYuen Cheung, Dapan Li, SenPo Yip, Qing Dan Yang, Chun-Yuen Wong, Sai-Wing Tsang, Johnny C Ho
Due to their superior physical properties, titanium dioxide (TiO2) nanotube arrays are one of the most investigated nanostructure systems in materials science until now. However, it is still a great challenge to achieve damage-free techniques to realize controllable, cost-effective, and high-performance TiO2 nanotube arrays on both rigid and flexible substrates for different technological applications. In this work, we demonstrate a unique strategy to achieve self-assemble crystalline, large-area, and regular TiO2 nanotube arrays on various substrates via hybrid combination of conventional semiconductor processes...
February 9, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28138542/knitting-and-weaving-artificial-muscles
#18
Ali Maziz, Alessandro Concas, Alexandre Khaldi, Jonas Stålhand, Nils-Krister Persson, Edwin W H Jager
A need exists for artificial muscles that are silent, soft, and compliant, with performance characteristics similar to those of skeletal muscle, enabling natural interaction of assistive devices with humans. By combining one of humankind's oldest technologies, textile processing, with electroactive polymers, we demonstrate here the feasibility of wearable, soft artificial muscles made by weaving and knitting, with tunable force and strain. These textile actuators were produced from cellulose yarns assembled into fabrics and coated with conducting polymers using a metal-free deposition...
January 2017: Science Advances
https://www.readbyqxmd.com/read/28138535/ultra-smooth-glassy-graphene-thin-films-for-flexible-transparent-circuits
#19
Xiao Dai, Jiang Wu, Zhicheng Qian, Haiyan Wang, Jie Jian, Yingjie Cao, Mark H Rummeli, Qinghua Yi, Huiyun Liu, Guifu Zou
Large-area graphene thin films are prized in flexible and transparent devices. We report on a type of glassy graphene that is in an intermediate state between glassy carbon and graphene and that has high crystallinity but curly lattice planes. A polymer-assisted approach is introduced to grow an ultra-smooth (roughness, <0.7 nm) glassy graphene thin film at the inch scale. Owing to the advantages inherited by the glassy graphene thin film from graphene and glassy carbon, the glassy graphene thin film exhibits conductivity, transparency, and flexibility comparable to those of graphene, as well as glassy carbon-like mechanical and chemical stability...
November 2016: Science Advances
https://www.readbyqxmd.com/read/28138529/epidermal-mechano-acoustic-sensing-electronics-for-cardiovascular-diagnostics-and-human-machine-interfaces
#20
Yuhao Liu, James J S Norton, Raza Qazi, Zhanan Zou, Kaitlyn R Ammann, Hank Liu, Lingqing Yan, Phat L Tran, Kyung-In Jang, Jung Woo Lee, Douglas Zhang, Kristopher A Kilian, Sung Hee Jung, Timothy Bretl, Jianliang Xiao, Marvin J Slepian, Yonggang Huang, Jae-Woong Jeong, John A Rogers
Physiological mechano-acoustic signals, often with frequencies and intensities that are beyond those associated with the audible range, provide information of great clinical utility. Stethoscopes and digital accelerometers in conventional packages can capture some relevant data, but neither is suitable for use in a continuous, wearable mode, and both have shortcomings associated with mechanical transduction of signals through the skin. We report a soft, conformal class of device configured specifically for mechano-acoustic recording from the skin, capable of being used on nearly any part of the body, in forms that maximize detectable signals and allow for multimodal operation, such as electrophysiological recording...
November 2016: Science Advances
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