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Ventricular Assist Devices

Ventricular Assist Devices. Topics in Bioengineering 09/24/2012. 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 09/24/2012

  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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