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Ventricular Assist Devices

Ventricular Assist Devices. Topics in Bioengineering. Increasing use of VADs as bridge to transplantation. Klotz et al. (2008) Prog Biophys Mol Biol. Overview of VAD types.

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Ventricular Assist Devices

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  1. Ventricular Assist Devices Topics in Bioengineering

  2. Increasing use of VADs as bridge to transplantation Klotz et al. (2008) ProgBiophys Mol Biol

  3. Overview of VAD types Klotz et al. (2008) ProgBiophys Mol Biol; http://my.clevelandclinic.org/heart/disorders/heartfailure/lvad_devices.aspx http://texasheart.org/Research/Devices/abiocor.cfm http://medgadget.com/2007/07/pediaflow_ventricular_assist_device.html

  4. The HeartMate II VAD Miller et al. (2007) NEJM. Figure 1 Griffith et al. (2001) Ann Thorac Surg. Figure 2

  5. Flow visualization around inlet stator and rotor Griffith et al. (2001) Ann Thorac Surg. Figure 3

  6. Tethered and untethered configurations Griffith et al. (2001) Ann Thorac Surg. Figures 4 and 5

  7. Pressure-flow relationships for HeartMate II Griffith et al. (2001) Ann Thorac Surg. Figure 6

  8. Baseline characteristics of the patients (1) 2.6-4.2 9-18 Normal: 55-70% Miller et al. (2007) NEJM. Table 1

  9. Baseline characteristics of the patients (2) N N N N N H - renal H - liver H - liver N H – tissue breakdown, various Miller et al. (2007) NEJM. Table 1

  10. Baseline characteristics of the patients (3) Increase contraction Edema Hypertension Hypertension, HF Arrhythmia Arrhythmia, HF Hypertension Arrhythmia (ventricular) Anticoagulant Anticoagulant Anticoagulant Miller et al. (2007) NEJM. Table 1

  11. Blood clotting cascade http://www.biosbcc.net/doohan/sample/htm/Hemostasis.htm

  12. NYHA Heart Failure Class http://www.abouthf.org/questions_stages.htm

  13. Functional status and quality of life Miller et al. (2007) NEJM. Table 2

  14. Functional status and quality of life Plot on graph? Miller et al. (2007) NEJM. Table 2

  15. Outcomes of the patients Miller et al. (2007) NEJM. Table 3

  16. Outcomes of the patients Miller et al. (2007) NEJM. Figure 2

  17. Adverse events in the study Miller et al. (2007) NEJM. Table 4

  18. Adverse events in the study Miller et al. (2007) NEJM. Table 4

  19. Testimony from a patient http://www.youtube.com/watch?v=_djouz093Us&feature=endscreen

  20. Questions for discussion • Is it worth the risk? • What major issues still need to be addressed? • What can BMEs do to improve VAD design? • What about for other patient populations (eg, women and children)? • Other thoughts, ideas, critiques? http://medgadget.com/2007/07/pediaflow_ventricular_assist_device.html

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