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Severe pulmonary hypertension (PH) has been considered a significant contraindication to cardiac transplantation. Ongoing clinical experience, however, has shown that temporary support using left ventricular assist devices (LVADs) in these patients can result in significant reductions in PH. A comprehensive review of the available literature regarding the use of LVADs in heart failure patients with PH was conducted. The existing literature to date supports the use of LVADs in heart failure patients with PH and demonstrates that significant reductions in PH in these patients can be achieved. This subsequently allows for safe and effective cardiac transplantation in patients who were previously excluded from this modality. For heart failure patients with severe PH, the use of LVADs can provide significant benefits by significantly reducing PH and allowing subsequent staged transplantation.

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Electrical lysis (EL) is the process of breaking the cell membrane to expose the internal contents under an applied high electric field. Lysis is an important phenomenon for cellular analysis, medical treatment, and biofouling control. This paper aims to review, summarize, and analyze recent advancements on EL. Major databases including PubMed, Ei Engineering Village, IEEE Xplore, and Scholars Portal were searched using relevant keywords. More than 50 articles published in English since 1997 are cited in this article. EL has several key advantages compared to other lysis techniques such as chemical, mechanical, sonication, or laser, including rapid speed of operation, ability to control, miniaturization, low cost, and low power requirement. A variety of cell types have been investigated for including protoplasts, E. coli, yeasts, blood cells, and cancer cells. EL has been developed and applied for decontamination, cytology, genetics, single-cell analysis, cancer treatment, and other applications. On-chip EL is a promising technology for multiplexed automated implementation of cell-sample preparation and processing with micro- or nanoliter reagents.

This article reports our experience with ventricular assist devices (VADs) as a bridge to cardiac transplantation. From 1991 to 2003, a total of 42 patients received a Thoratec VAD (Thoratec Laboratories Corporation Inc., Pleasanton, CA, U.S.A.) (Group T) and 12 patients received a Novacor VAD (WorldHeart Corporation, Ottawa, Canada) (Group N). Thirty Thoratec patients were transplanted compared to six in the Novacor group. Four more Novacor patients are still supported. Of the transplanted patients, 87% survived to hospital discharge in Group T and 67% in Group N. Infections affected 29% and 50% of Group T patients during support and post-transplantation, respectively, compared to 25% and 0%, respectively, in Group N. Neurologic complications affected 33% of patients in each group during support. Reopening rates for bleeding during support were 45% and 42% in Groups T and N, respectively. There were no significant differences in outcomes between the two groups. Our study demonstrated the effectiveness of VADs in bridging mortally ill cardiac patients to successful heart transplantation.

Rotary blood pumps often require a constant operating voltage. To meet this requirement and to eliminate the need for percutaneous leads, a voltage-regulated transcutaneous energy transfer (TET) system has been developed. Voltage regulation is achieved by using a transcutaneous infrared feedback control loop operating on a 890 nanometer (nm) wavelength. In vitro testing of the system developed has shown that output voltage can be maintained to within 0.2 V of nominal (14.5 V) for delivered powers up to 50 watts (W) and coil separations of between 3 and 10 mm. Power transfer efficiencies were determined to be from 68% to 72% over the tested range of coil separations and output currents from 1.5 to 3.6 amperes (A). This system has demonstrated acceptable performance in regulating output voltage while transferring power inductively without using percutaneous connections. By integrating this type of TET system with an implanted rotary blood pump, the quality of life for the device recipient could be improved.

A transcutaneous energy transfer (TET) system has been developed to power implantable devices such as artificial hearts, defibrillators, and electrical stimulators. Transcutaneous coupling of power to these implanted de‐vices remains a favorable alternative as percutaneous lines are avoided in order to eliminate the potential of infection and allow patient mobility. In vitro, in vivo, ex vivo, and human cadaver studies of the electrohydraulic ventricular assist device TET have demonstrated that power can be transmitted over a range of skin thicknesses of 3–15 mm and can tolerate radial misalignments of up to 20 mm. Sensitivity to coil separation and radial misalignment variations has been addressed by the development of an auto‐tuning TET. The system has only a 10% attenuation in secondary coil voltage when metallic objects are in contact with the primary coil. The system has demonstrated a power transfer efficiency of 60–80% for power demands from 5 to 70 W. The TET secondary coil will provide an output voltage of 10–25 V for current demands from 0.5 to 4.0 A. TET chronic studies in porcine models have demonstrated no adverse effect to the tissue when up to 40 W of power can be delivered to an implanted load without the tissue‐contacting surface of the coil exceeding 42°C. In conclusion, the TET is a feasible alternative for tether‐free power transmission.