Past and present of cardiocirculatory assist devices: a comprehensive critical review

Rigatelli, Gianluca; Santini, Francesco; Faggian, Giuseppe

doi:10.3724/sp.j.1263.2012.05281

Cited by 12 publications

(11 citation statements)

References 65 publications

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“…The first generation pulsatile BiVADs have saved many lives, but are limited by their bulkiness, the necessity of a large external pneumatic driver that inhibits patient mobility, infection at the driveline site, and thrombus formation. Some first generation BiVADs include AbioMed BVS5000 (AbioMed), Berlin Heart EXCOR (Berlin Heart), and Medos HIA-VAD (Stolberg, Germany) [27,30].…”

Section: The History Of Cardiac Assist Devicesmentioning

confidence: 99%

Cardiac Assist Devices: Early Concepts, Current Technologies, and Future Innovations

Han

Trumble

2019

Bioengineering

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Congestive heart failure (CHF) is a debilitating condition that afflicts tens of millions of people worldwide and is responsible for more deaths each year than all cancers combined. Because donor hearts for transplantation are in short supply, a safe and durable means of mechanical circulatory support could extend the lives and reduce the suffering of millions. But while the profusion of blood pumps available to clinicians in 2019 tend to work extremely well in the short term (hours to weeks/months), every long-term cardiac assist device on the market today is limited by the same two problems: infections caused by percutaneous drivelines and thrombotic events associated with the use of blood-contacting surfaces. A fundamental change in device design is needed to address both these problems and ultimately make a device that can support the heart indefinitely. Toward that end, several groups are currently developing devices without blood-contacting surfaces and/or extracorporeal power sources with the aim of providing a safe, tether-free means to support the failing heart over extended periods of time.

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Section: The History Of Cardiac Assist Devicesmentioning

confidence: 99%

Cardiac Assist Devices: Early Concepts, Current Technologies, and Future Innovations

Han

Trumble

2019

Bioengineering

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“…Neonatal HT is uncommon; however, significant progress has been made in the treatment of CHD, including new medical and device therapies during the past 20 years (34). Clinical studies focus on two major pharmacological agents, beta-blockers and angiotensin-converting enzyme inhibitors, to treat CHD patients (35–37).…”

Section: Heart Transplantation and Medical And Device Therapies For Chdmentioning

confidence: 99%

“…A variety of assist devices, such as left ventricle assist devices, and a total artificial heart have been used to decrease the mortality and morbidity in patients awaiting HT (34). Although many assistive devices have been developed as replacement therapy for critically ill patients with CHD to support their failing heart, limitations, including significant mortality and morbidity after implantation of assist devices, device reliability, cardiac arrhythmia, risk of infection, and anticoagulation, should be considered (34,42).…”

Section: Heart Transplantation and Medical And Device Therapies For Chdmentioning

confidence: 99%

“…Although many assistive devices have been developed as replacement therapy for critically ill patients with CHD to support their failing heart, limitations, including significant mortality and morbidity after implantation of assist devices, device reliability, cardiac arrhythmia, risk of infection, and anticoagulation, should be considered (34,42). …”

Section: Heart Transplantation and Medical And Device Therapies For Chdmentioning

confidence: 99%

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The current status and future of cardiac stem/progenitor cell therapy for congenital heart defects from diabetic pregnancy

et al. 2017

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Pregestational maternal diabetes induces congenital heart defects (CHDs). Cardiac dysfunction after palliative surgical procedures contributes to the high mortality of CHD patients. Autologous or allogeneic stem cell therapies are effective for improving cardiac function in animal models and clinical trials. c-kit+ cardiac progenitor cells (CPCs), the most recognized CPCs, have the following basic properties of stem cells: self-renewal, multicellular clone formation, and differentiation into multiple cardiac lineages. However, there is ongoing debate regarding whether c-kit+ CPCs can give rise to sufficient cardiomyocytes. A new hypothesis to address the beneficial effect of c-kit+ CPCs is that these cells stimulate endogenous cardiac cells through a paracrine function in producing a robust secretome and exosomes. The values of other cardiac CPCs, including Sca1+ CPCs and cardiosphere-derived cells, are beginning to be revealed. These cells may be better choices than c-kit+ CPCs for generating cardiomyocytes. Adult mesenchymal stem cells are considered immune-incompetent and effective for improving cardiac function. Autologous CPC therapy may be limited by the observation that maternal diabetes adversely affects the biological function of embryonic stem cells and CPCs. Future studies should focus on determining the mechanistic action of these cells, identifying new CPC markers, selecting highly effective CPCs, and engineering cell-free products.

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“…The ventricular assist devices (VADs) can be classified by generation, as described by Gianluca, Francesco and Giuseppe (2013). Pulsatile devices are the first generation of pumps introduced clinically, they have large sizes, multiple moving parts, and can be implanted intra-corporeally or para-corporeally.…”

Section: Ventricular Assist Devicesmentioning

confidence: 99%

Topology optimization method applied to ventricular assis device impeller and volute design.

Sá¹

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Dispositivos de auxílio ventricular (DAV) são essencialmente bombas de pequena escala que auxiliam o bombeamento de sangue. O projeto de DAVs tem como principal requisito baixa tensão de cisalhamento a fim de evitar a destruição de hemácias. As topologias do rotor e voluta dessas bombas influenciam diretamente a condição do escoamento e consequentemente a tensão de cisalhamento. Este trabalho visa o otimizar o rotor e a voluta de um DAV radial, baseando-se no método de otimização topológica. A solução das equações constitutivas é feita utilizando-se o método de elementos finitos para a modelagem do escoamento de sangue, em um referencial rotativo no caso do rotor, e fixo no caso da voluta. O escoamento foi modelado com base no escoamento fluido em meio poroso utilizando a equação de Brinkman; além disso é considerado escoamento turbulento utilizando-se o modelo de Spalart-Allmaras. A função objetivo considerada é a minimização da energia de dissipação viscosa, visando-se, indiretamente, a redução da taxa de hemólise. A implementação dos algoritmos é realizada utilizando-se o ambiente FEniCS em conjunto com as bibliotecas do dolfin-adjoint e pyIpopt. As topologias otimizadas foram construídas utilizando-se impressão 3D. Os protótipos foram testados com água e os resultados utilizados para calibrar um modelo computacional 3D de um DAV completo. Por fim, o modelo foi simulado com sangue operando a 5 l/min e 100mmHg, e comparado com um rotor de pás retas, observando-se uma redução de 20% no valor de dissipação viscosa.

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Past and present of cardiocirculatory assist devices: a comprehensive critical review

Cited by 12 publications

References 65 publications

Cardiac Assist Devices: Early Concepts, Current Technologies, and Future Innovations

Cardiac Assist Devices: Early Concepts, Current Technologies, and Future Innovations

The current status and future of cardiac stem/progenitor cell therapy for congenital heart defects from diabetic pregnancy

Topology optimization method applied to ventricular assis device impeller and volute design.

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