• Title/Summary/Keyword: LVAD

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Management of Acute Fulminant Myocarditis Using a Left Ventricular Assist Device - A case report - (좌심실 보조장치를 이용한 전격성 심근염의 치료 - 1례 보고 -)

  • Kang, Shin-Kwang;Park, Sang-Soon;Na, Myung-Hoon;Yu, Jae-Hyeon;Lim, Seung-Pyung;Lee, Young;Seong, In-Whan
    • Journal of Chest Surgery
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    • v.34 no.6
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    • pp.490-493
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    • 2001
  • A 17 year-old high school girl was admitted for anterior chest pain. Pulmonary edema and circulatory collapse progressed in spite of the medical treatment and intra-aortic balloon pump. Left ventricular assist device(LVAD, Bio-Pump, Medtronic Bio-Med, USA) was instituted under the impression of acute fulminant myocarditis. The inlet cannula was inserted in the left atrium(LA) via left submammary anterior thoracotomy. Biopsy was taken from left atrial appendage. The outlet cannula inserted to the left femoral artery using PTFE cuff. After 158 hours of extracorporeal circulation, LVAD was able to be weaned successfully with nearly normalized LV motion on echocardiogram, Coxsakievirus was identified with immunochemistry and serum neutralization test. She was discharged without any heart failure symptoms after 23 days of hopitalization.

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The Impact of Intrapericardial versus Intrapleural HeartMate 3 Pump Placement on Clinical Outcomes

  • Salna, Michael;Ning, Yuming;Kurlansky, Paul;Yuzefpolskaya, Melana;Colombo, Paolo C.;Naka, Yoshifumi;Takeda, Koji
    • Journal of Chest Surgery
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    • v.55 no.3
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    • pp.197-205
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    • 2022
  • Background: The integrated design of the HeartMate 3 (Abbott Laboratories, Chicago, IL, USA) affords flexibility to place the pump within the pericardium or thoracic cavity. We sought to determine whether the presence of a left ventricular assist device (LVAD) in either location has a meaningful impact on overall patient outcomes. Methods: A retrospective cohort study was conducted of all 165 patients who received a HeartMate 3 LVAD via a median sternotomy from November 2014 to August 2019 at our center. Based on operative reports and imaging, patients were divided into intrapleural (n=81) and intrapericardial (n=84) cohorts. The primary outcome of interest was in-hospital mortality, while secondary outcomes included postoperative complications, cumulative readmission incidence, and 3-year survival. Results: There were no significant between-group differences in baseline demographics, risk factors, or preoperative hemodynamics. The overall in-hospital mortality rate was 6%, with no significant difference between the cohorts (9% vs. 4%, p=0.20). There were no significant differences in the postoperative rates of right ventricular failure, kidney failure requiring hemodialysis, stroke, tracheostomy, or arrhythmias. Over 3 years, despite similar mortality rates, intrapleural patients had significantly more readmissions (n=180 vs. n=117, p<0.01) with the most common reason being infection (n=68/165), predominantly unrelated to the device. Intrapleural patients had significantly more infection-related readmissions, predominantly driven by non-ventricular assist device-related infections (p=0.02), with 41% of these due to respiratory infections compared with 28% of intrapericardial patients. Conclusion: Compared with intrapericardial placement, insertion of an intrapleural HM3 may be associated with a higher incidence of readmission, especially due to respiratory infection.

Hydraulic Force and Impeller Evaluation of a Centrifugal Heart Pump

  • Timms, D.L;Tan, A.C.C;Pearcy, M-J;Mcneil, K;Galbraith, A
    • Journal of Advanced Marine Engineering and Technology
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    • v.28 no.2
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    • pp.376-381
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    • 2004
  • A rig was constructed to test the performance characteristics and compare the hydraulic forces exerted on a centrifugal type artificial heart impeller. A conventional shaft. seal and bearing system. while driven by a small electric motor. supported the impeller which was separated from the pump casing by a six degree of freedom force transducer (JR3 Ine). Radial (x. y) and axial (z) hydraulic forces were recorded and compared. At physiological operating conditions. the results indicate that the double entry/exit centrifugal pump encounters a smaller radial force and significantly reduced axial thrust. These experimental results are valuable in the design of a magnetic bearing system to suspend the impeller of a centrifugal artificial heart pump. This experimental technique may also be applied to evaluate the required capacity and predict the lifetime of contact bearings in marine pumps.

Experimental Flow Visualisation of an Artificial Heart Pump

  • Tan, A.C.C.;Timms, D.L.;Pearcy, M.J.;McNeil, K.;Galbraith, A.
    • Journal of Advanced Marine Engineering and Technology
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    • v.28 no.2
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    • pp.210-216
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    • 2004
  • Flow visualization techniques were employed to qualitatively visualize the flow patterns through a 400% scaled up centrifugal blood pump. The apparatus comprised of a scaled up centrifugal pump. high speed video camera. Argon Ion Laser Light Sheet and custom coded particle tracking software. Reynolds similarity laws are applied in order to reduce the rotational speed of the pump. The outlet (cutwater) region was identified as a site of high turbulence and thus a likely source of haemolysis. The region underneath the impeller was identified as a region of lower flow.

Postcardiotomy Mechanical Circulatory Support in Congenital Heart Diseases (소아개심술 후 시행한 순환보조장치의 임상적 고찰)

  • 권오춘;이영탁
    • Journal of Chest Surgery
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    • v.33 no.5
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    • pp.385-390
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    • 2000
  • Background: To review the experience that used both ventricular assist device(VAD) and extracorporeal membrane oxygenation(ECMO) for children with congential heart disease requiring postcardiotomy mechanical circulatory support. Material and Method: Between March 1993 and May 1995, we applied mechanical assist device using centrifugal pump to the 16 patients who failed to be weaned from cardiopulmonary bypass(n=15) or had been in cardiogenic shock in intensive care unit(n=1). The diagnosis were all congenital heart diseases and the ages of patients ranged from 20 days to 10 years (mean age=2.5$\pm$3.5 years). Result: The methods of mechanical circulatory support were LVAD(n=13), BVAD (n=1), and ECMO(n=2). The mean assist times were 54.0$\pm$23.7 hours. Post-assist complications were in orders: bleeding, acute renal failure, ventricular failure, respiratory failure, infection, and neurologic complication. It was possible for 9 patients(56.3%) to be weaned from assist device and 5 patients(31.3%) were discharged from hospital. There was no statistical significant between hospital discharged group and undischarged group by age, body weight, cardiopulmonary bypass time, and assist time. Conclusion: The ventricular assist device is an effective modality in salvaging the patient who failed to be weaned from cardiopulmonary bypass, but multiple factors must be considered for improving the results of mechanical circulatory support ; such as patient selection, optimal time of starting the assist device, and prevention and management of the complications.

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Evaluation of Pneumatic Left Ventricular Assist Device for Animal Experiment (동물실험을 통한 공압식 좌심실보조장치의 평가)

  • Lee, H.S.;Oh, H.J.;Lee, S.H.;Kim, S.H.;Seo, P.W.;Park, S.S.;Rhee, K.H.;Ahn, H.;Hwang, S.O.
    • Proceedings of the KOSOMBE Conference
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    • v.1998 no.11
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    • pp.235-236
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    • 1998
  • The purpose of this paper is to develop diaphragm type pneumatic Left Ventricular Assist Device(LVAD) for clinical application and to evaluate its performance through the mock circulation and animal experiment. The blood housing and diaphragm are made by polyurethane. The relations of cardiac output us. beat rate and cardiac output vs. systolic-to-diastolic rate was estimated through the mock test and hemodynamic waves are recorded for the evaluation of VAD. We performed animal experiment and 4 animals survived more than 24hrs. As a result, the hemodynamic data and waves showed this system can be applicable to the animal experiment.

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Adaptively Trained Artificial Neural Network Identification of Left Ventricular Assist Device (적응 학습방식의 신경망을 이용한 좌심실보조장치의 모델링)

  • Kim, Sang-Hyun;Kim, Hun-Mo;Ryu, Jung-Woo
    • Journal of Biomedical Engineering Research
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    • v.17 no.3
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    • pp.387-394
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    • 1996
  • This paper presents a Neural Network Identification(NNI) method for modeling of highly complicated nonlinear and time varing human system with a pneumatically driven mock circulatory system of Left Ventricular Assist Device(LVAD). This system consists of electronic circuits and pneumatic driving circuits. The initiation of systole and the pumping duration can be determined by the computer program. The line pressure from a pressure transducer inserted in the pneumatic line was recorded System modeling is completed using the adaptively trained backpropagation learning algorithms with input variables, heart rate(HR), systole-diastole rate(SDR), which can vary state of system. Output parameters are preload, afterload which indicate the systemic dynamic characteristics. Consequently, the neural network shows good approximation of nonlinearity, and characteristics of left Ventricular Assist Device. Our results show that the neural network leads to a significant improvement in the modeling of highly nonlinear Left Ventricular Assist Device.

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Development of an Algorithm for Regulation of Inlet Blood Flow in Electrohydraulic Left Ventricular Assist Device Using Fuzzy Logic (퍼지로직을 이용한 전기유압식 좌심실 보조장치의 유입혈류량 조절 알고리즘의 개발)

  • Choi, Jae-Soon;Choi, Won-Woo;Jo, Yong-Ho;Park, Seong-Keun;Min, Byoung-Goo
    • Proceedings of the Korean Institute of Intelligent Systems Conference
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    • 1995.10b
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    • pp.387-392
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    • 1995
  • 전기 유압식 좌심실 보조장치에서 모터 전류 파형을 정보로 하여 작동기의 이완기 속도를 조절함으로써 좌심방으로부터 유입되는 혈류량을 조절하는 알고리즘을 개발하였다. 좌심실 보조장치(Left Ventricular Assist Device, LVAD)는 허혈성 심장질환 등으로 좌심실 의 혈액 박출 기능이 저하된 환자에게 시술하여 정상 상태의 심박출량을 유지할 수 있도록 하는 보조 혈액 박출 기능이이다. 전기 유압식 좌심실 보조장치에서는 혈액의 유입이 능동 적으로 이루어지므로, 좌심방 함몰로 인한 심근 손상 및 외부 공기 유입으로 인한 색전증을 방지하기 위해 유입혈류량을 현재 좌심방내의 상태에 따라 적절히 조절해 주어야 한다. 좌 심방 내의 혈액량 정도는 혈액을 유입해 내는 작동기의 이완기 동작 시에 소모되는 에너지 크기에 반영되고, 작동기를 구동하는 모터에 들어가는 전류의 크기는 작동기에 공급되는 에 너지에 비례하므로, 이전류 파형의 정보들을 통해 좌심방내의 상태를 추정해 볼 수 있다. 본 논문에서는 퍼지로직을 적용하여 모터 전류 파형의 정보들을 통해 좌심방 내의 상태를 추정 해 볼 수 있다. 본 논문에서는 퍼지로직을 적용하여 모터 전류 파형의 이상 유무를 판단한 뒤 에에 따라 작동기의 이완기 속도를 조절하는 알고리즘을 개발하여 모의순환장치 실험을 통해 그 실효성을 검증한 결과를 정리하였다.

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In Vivo Blood Compatibility of PU-PEO-SO3 as Coating Material for Blood Sac of Left Ventricular Assist Device ( LVAD) (좌심실보조장치의 혈액주머니용 코팅재료로서 PU-PEO-SO3의 in vivo 혈액적합성에 관한 연구)

  • 한동근;김종원
    • Journal of Biomedical Engineering Research
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    • v.15 no.1
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    • pp.19-26
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    • 1994
  • Sulfonated poly (ethyleneoxide)-grafted polyurethane (PU-PEO-$SO_3$) prepared by bulk modification was coated on a blood sac for electrohydraulic left ventricular assist device (ELVAD) implanted in dogs and its in vivo blood compatibility on shear stress was studied as compared with untreated Po. The effect of the wall shear stress on the protein adsorption unlike platelet adhesion is dependent on the surface characteristics of the material, although less proteins seem to be adsorbed in the region of the high shear stress. The thickness of total proteins adsorbed on PU-PEO-SOJ (400 ${\AA}$) by trans¬mission electron microscopy(TEM) was considerably lower than that of untreated PU(l,000~1,600 ${\AA}$), but PU-PEO-$SO_3$ showed high albumin adsorption, low fibrinogen and IgG adsorption, and low platelet adhesion as compared with untreated PU, suggesting that PU-PEO-$SO_3$ is more in vivo blood compatible. Therefore, it appears that such a blood compatible PU-PEO-$SO_3$ is useful for blood contacting biomaterials including artificial organs.

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