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Biomedical subjects

K Imachi

Publications and source records attributed to K Imachi.

71 records · Page 4Linked to original sources

Changes with respect to time in the in vivo adsorption of plasma proteins onto artificial heart blood pumps.

The distribution of adsorbed plasma proteins (albumin, IgG, and fibrinogen) on 10 artificial heart blood pumps coated with 2 segmented polyurethanes was evaluated quantitatively after long-term in vivo experiments with goats to determine how the adsorption of plasma proteins on the pumps was affected by the kinds of biomaterials used, and by the pumping duration. The adsorbed plasma proteins on the materials were determined quantitatively using the iodine-125 conjugated antibody method. Microscopically, the adsorbed plasma proteins were marked by the gold colloid conjugated antibody method, and analyzed using a field emission scanning electron microscope. The macroscopic results showed that: 1) the adsorbed plasma proteins on KP-13 were more evenly and finely distributed than those on Cardiothane; 2) with KP-13, the adsorption of IgG and albumin at the center of the pumps was significantly less than in the peripheral areas, and the adsorbed IgG and albumin decreased significantly as the pumping duration increased; 3) in contrast, the adsorbed fibrinogen increased significantly with time; and 4) with Cardiothane, the tendencies for adsorbed IgG and albumin to decrease, and for adsorbed fibrinogen to increase, were less significant than with KP-13. Microscopically, the gold colloids marking plasma proteins were found to not cover the whole of the surface, but were found scattered randomly or in clusters, with no relationship observed between the distributions of the three plasma proteins.(ABSTRACT TRUNCATED AT 250 WORDS)

Adsorption↗

The second and third model of the flow transformed pulsatile total artificial heart.

For the purpose of future total implantation, a new pulsatile total artificial heart, a flow transformed pulsatile total artificial heart (FTPTAH), in which the continuous flow from a single centrifugal pump (CFP) was converted to pulsatile flow by switching two three-way valves that could alternately perfuse the systemic and pulmonary circulation, was proposed, and the data from the prototype model were reported. As the next step, the second model, in which a CFP and a spool valve (SV) driven with a solenoid were fabricated in one piece, was made and tested in a mock circulatory system. The system could send 4.7 L/min of pulsatile output alternately to the pulmonary artery and aorta, with 30 and 100 mmHg afterload, respectively, at 3000 rpm CFP. However, three problems were encountered: the output was not enough, mixture or inversion of venous and arterial blood in the CFP would occur, and heat generation at the solenoid was very severe. To solve these problems, a third model was designed in the current study. To increase pump output, hydrodynamic analysis was performed. The SV was divided into inlet and outlet to control the blood mixture or inversion. To suppress heat generation, each SV was driven back and forth by two solenoids, one on each side of the SV. The model revealed satisfactory results in a mock circulatory system.

Biomedical Engineering↗

A new apparatus for chronic observation of the microcirculation in situ to evaluate artificial organ performance.

Chronic study of the peripheral circulation and metabolism is very important in evaluation of artificial organ performance. However, there has been no way to observe the microcirculation in situ, chronically and continuously, without restriction. In this study, the authors developed a new apparatus that could be implanted and connected to an artificial organ that would allow continuous observation of the microcirculation while the subject is awake. The apparatus uses a charge coupled device (CCD) under a new principle: thin living tissue, such as mesentery, is put directly on a highly integrated CCD and transilluminated with a light emitting diode (LED). The vascular nets in the tissue are projected onto the CCD like a contact photograph, which is sent to a television screen and can be analyzed for motion and function. A 0.5 inch CCD with 25K pixels was used in this study. The cover glass of the CCD was removed so the tissue would be able to directly contact the CCD surface. The CCD, as well as LED, were molded with hard polyurethane as electrical insulation. The apparatus is 35 mm in diameter and 10 mm high with a micro stand for lighting with the LED, which is easy to implant in a goat or calf. The resolution of this apparatus was tested by putting a micro scale on the CCD surface. Several tenths of micrometers could be seen. In an animal experiment with a rabbit, configurations of arterioles and venules and their motions could be observed continuously for a night until the electrical insulation was broken. This method might be a strong weapon in artificial organs research.

Animals↗

Results of animal experiments using an undulation pump total artificial heart: analysis of 10 day and 19 day survival.

An undulation pump is a special rotary blood pump in which rotation of a brushless DC motor is transformed to an undulating motion by a disc in the pump housing attached by means of a special link mechanism. In the blood pump, a closed line between the disc and housing moves from the inlet to the outlet by this undulating disc motion, which sucks and pushes the blood from the inlet to the outlet. Because the same phenomena occurs at both sides of the disc, a continuous flow is obtained when the motor rotational speed is constant. The pump flow pattern can be easily changed from continuous flow to pulsatile flow by controlling the motor drive current pattern. A seal membrane made of segmented polyurethane protects the blood from invading the link mechanism as well as the motor. UPTAH is fabricated with two undulation pumps and two brushless DC motors. Its size is 75 mm in diameter and 80 mm long, and it has one of the great advantage of no compliance chamber required in the system. UPTAHs were implanted under cardiopulmonary bypass (CPB) into the chest cavities of 16 goats, each weighing between 41 and 72 kg. No anticoagulant and antiplatelet agent was used after the surgery. The left atrial pressure was automatically controlled to prevent its elevation and sucking of the atrial wall into the atrial cuff. The following results were obtained: (1) UPTAHs fit well into all the goats; (2) the longest survival was 19.8 days, the cause of death was bleeding from the aortic anastomosis; (3) No thrombus was observed in the blood pump despite no anticoagulant use. Hemolysis depended upon the length of CPB during surgery. When CPB time was within 2 hours, hemolysis level returned to baseline within a few days of the surgery. UPTAH is a promising implantable TAH, because of its small size and easy controllability.

Animals↗

Automatic monitoring system for artificial hearts using self organizing map.

This study presents an automatic monitoring system for artificial hearts. The self organizing map (SOM) was applied to monitoring and analysis of an aortic pressure (AoP) signal measured from an adult goat equipped with a total artificial heart. In the proposed system, two different SOMs were used to detect and classify abnormalities in the measured AoP signal. In the first stage, an ordinary SOM, taught with only normal AoP data, was used for detection of abnormalities on the basis of the quantization error in the real-time monitoring task. In the second stage, a supervised SOM was used for classification of abnormalities. The supervised SOM can be regarded as an ordinary SOM with an extra class vector for solving the classification problem. The class vector is assigned to every node in the second SOM as an output weight learned according to Kohonen's learning rule. The effectiveness of detection and classification of abnormalities using these two SOMs was confirmed.

Animals↗

Suppression of the natriuretic effects of exogenous atrial natriuretic peptide in animals with total artificial hearts.

Atrial natriuretic peptide (ANP) was administered intravenously to three goats at a dose of 0.1 micrograms/kg/min for 40 min both before total artificial heart (TAH) placement and at 1, 7, and 14 postoperative weeks to determine whether exogenous ANP exhibits the same effect on animals with TAHs as it does on normal animals. No significant changes in the increases in plasma levels of ANP and cyclic guanosine monophosphate (c-GMP) were observed during ANP administration after TAH insertion. In preoperative animals, urine volume and urinary sodium excretion increased greatly during ANP administration, but this natriuretic effect was strongly suppressed in TAH animals. The changes in the decreases in arterial pressure and in central venous pressure (CVP) or right atrial pressure that occurred during the administration of ANP were not significant either pre- or post-operatively. Thus, only the natriuretic effect of ANP on the kidney was significantly suppressed in TAH animals, which might be due to some down-regulation of ANP receptors in the kidney, the production of some antagonists of ANP, sympathetic hypertonicity, or the elevation of CVP.

Animals↗

Blood compatibility of the jellyfish valve without anticoagulant.

The blood compatibility of the jellyfish valve was studied. Artificial heart (AH) blood pumps incorporating jellyfish valves were connected to 18 goats as total artificial hearts (TAHs) and pumped for 1 to 125 days without anticoagulant or antiplatelet drugs. No thrombus was formed on the valve membrane or around the valve seat. Scanning electron microscopy showed almost no platelet deposition or microfibrin clot formation on the valve membrane, including its central region; the spokes of the valve seat were also free from platelet and microfibrin clots. No calcification was observed during these tests, and plasma free hemoglobin was between 2 and 7 mg/dl. The jellyfish valve revealed good blood compatibility, even without anticoagulant use.

Animals↗

A new pulsatile total artificial heart using a single centrifugal pump.

A new pulsatile total artificial heart (TAH) system, combining a single centrifugal pump (CFP) with two three-way valves, was developed. One port of each three-way valve was connected to the inlet and outlet of a CFP, respectively. The other two ports of each valve ware connected to the right and left atrium, pulmonary artery, and aorta. The CFP can perfuse the pulmonary and systemic circulation alternately with pulsatile flow. A prototype system composed of a Sarns' CFP and solenoid valves was connected to a mock circulatory system resulting in 1) a pulsatile TAH that could be produced with a single CFP, 2) 5 L/min of pulsatile output with a normal flow wave form that can be obtained alternately on the right and left side by switching the solenoid valves, and 3) flow balance between the left and the right that could be controlled easily by the length of switching duration. This new system could be miniaturized and is feasible for a totally implantable TAH.

Blood Flow Velocity↗

An artificial heart driven by liquid gas.

An artificial heart (AH) driving system, in which a sac or diaphragm type blood pump is liquid gas driven, is designed. The working mechanism of this system is as follows: 1) liquid gas is used for the driving source; 2) a liquid gas is stored in its liquid state in the circuit; 3) a liquid gas is vaporized, and the vaporizing pressure squeezes the blood pump, causing ejection of blood; 4) vaporized gas is aspirated and compressed by a small compressor to liquefaction through the heat exchanger, then negative pressure is applied to the blood pump and blood is aspirated; and 5) the blood pump is driven in this closed cycle. To demonstrate the mechanism of this system, a prototype was developed using Freon 114 as the liquid gas. In this system, the maximum flow of the AH at a 100 pulse per minute rate, was about 6.9 L/min, using a 90 ml sac type blood pump. The advantages of this AH driving mechanism are as follows: 1) a small system is available because pressure chambers are not necessary; 2) a biventricular system is available, with a single compressor; 3) no compliance chamber is necessary if the system is small enough to be implanted.

Ammonia↗

Multi-institutional evaluation of the Tokyo University Ventricular Assist System.

A total of 61 VASs developed in Tokyo University were evaluated at 21 institutions in the period 1985-1989 for determination of its reliability and effectiveness. The system is comprised of a pneumatic sack-type pump (Nippon Zeon Co.), and its driving console (Aishin Seiki Co.). The stroke volume of the pump is 40 ml and blood contacting surfaces are coated with Cardiothane. Ages of the patients (pts) ranged from 12-82 yrs (mean 58 yrs). VASs were used in the assist mode of LVAD (54 pts), RVAD (5 pts) and BVAD (2 pts). Most of the cases (58 pts) included postocardiotomy cardiogenic shock after surgery for ischemic (28 pts), valvular (22 pts), both ischemic and valvular (7 pts) and congenital (1 pt) heart diseases. Average duration of the assist ranged from 1 hr-20 days (mean 5.6 dys). The VADs could be weaned in 34 cases (56%) and among these, 13 cases (21%) survived to discharge from the hospital. Causes of death in cases which could be weaned from the VAD included multiple organ failure/due to delayed institution of adequate circulatory support, renal failure and systemic infection. Small and minute thrombus formations were noted in 7 cases however, no pump originated thromboembolism were complicated. No troubles of the pump including leakage nor breakage, no mechanical failures of the driving consoles were experienced in any of the cases. Thus, it is concluded that the system was proved to be clinically effective and reliable.

Adolescent↗

Is atrial natriuretic polypeptide a cause of pathophysiology in total artificial heart animals?

The purpose of this study was to clarify whether plasma ANP levels (p-ANP) are abnormal in TAH animals, and if ANP plays an important role in circulatory failure in TAH animals. In five TAH goats that survived for 51-171 days, changes in hemodynamic parameters, plasma levels of renin, angiotensin I and II, aldosterone (p-RAA), and p-ANP were measured, and correlations between p-ANP and other parameters were studied, and histologic study of ANP and assay of the ANP content in atrial tissue was undertaken. Generally, p-ANP of TAH goats fell temporarily after surgery but then recovered to preoperative levels. Histopathologic studies of atrial tissue and ANP granules proved almost normal, although the coronary blood supply was occluded for more than 170 days; the ANP content in the atrium did not show significant changes after 51 days of TAH pumping. In one case prominent correlations between p-ANP and p-RAA were observed, and in another case significant correlation between p-ANP and arterial pressure was observed. However, these correlations were not observed in every case. In TAH goats the plasma ANP level did not increase in spite of high atrial pressures. Plasma ANP levels in TAH animals are almost normal. In TAH animals no role in the pathogenesis of hemodynamic abnormalities is played by abnormality of plasma ANP levels. However, TAH animals may display an abnormality in sensitivity to the p-ANP.

Aldosterone↗

Long-term preservation of a beating heart in an artificial environment.

The natural heart could be preserved in the beating state, with appropriate afterload, for more than 24 hrs if supported by blood compatible artificial organs and biomedical engineering techniques. An artificial environment was developed using this philosophy. The system was constructed from four subsystems: circulatory, respiratory, metabolic, and environmental. In the circulatory subsystem, diastolic pressure was held at 70 to 100 mmHg by computer aided peripheral resistance, and a left ventricular assist device (LVAD) could be added when cardiac function was weakened. The respiratory subsystem was composed of an artificial lung and computer aided gas mixer for O2, CO2, and air, which kept blood PO2 and PCO2 within physiologic levels. In the metabolic subsystem, glucose and insulin were injected by infusion pump so as to maintain blood sugar within 100 to 200 mg/dl, whereas the environmental system preserved the isolated heart at 37 degrees C in a sterile water bath. Goats' hearts were connected to this system, and continued to beat for a maximum of 24 hours.

Animals↗

Predictive control by physical activity rate of a total artificial heart during exercise.

No control method has yet been established for the total artificial heart (TAH) during exercise. As the simple intrinsic control method does not significantly increase cardiac output (CO), this study attempted to develop a new TAH control method that increases the CO during exercise in a manner similar to a natural heart (NH) by predicting changes in CO as a time function (TF) at various treadmill speeds. The control method for TAH was as follows: 1) an arbitrary grade of treadmill exercise was loaded onto the TAH goat; 2) a TF at this grade of treadmill exercise was determined from the physical activity rate (PAR) measurement, defined as the time average of the increase in vertical acceleration of the body; 3) operating parameters of both pumps were controlled in accordance with the TF using the computer algorithm. With the predictive control method changes in CO in the TAH were almost the same as in the NH, whereas no increase in CO occurred with the fixed control method (FC), in which operating parameters remained unchanged during exercise. Changes in blood lactate and catecholamines tended to be less than with the FC.

Animals↗

A newly designed jellyfish valve for an artificial heart blood pump.

Bjork-Shiley and Hall valves used in most artificial heart blood pumps have often induced problems, which include 1) An expensive valve must be used even when the AH is used for only a few days, 2) Ring thrombus was often formed at the interface between the valve ring and blood pump, seamless fabrication was not possible, and 3) Mechanical failure often occurred. To improve these circumstances, a new jellyfish valve was designed and manufactured. The valve has a simple structure: The center of a thin circular polyurethane membrane is fixed on a polyurethane base plate, which has many holes or slits to reduce flow resistance and help hold the membrane during the diastolic phase. In a mock circulation study, the valve displayed performance similar to the Bjork-Shiley valve. A small amount of regurgitant flow was observed at valve closure, in comparison with the Bjork-Shiley valve. It was recognized in the flow visualization study that the central region of the membrane was washed out well by the flapping of the membrane. This jellyfish valve is promising for use in a AH blood pump.

Equipment Design↗

Can total artificial heart animals control their TAH by themselves? One year survival of a TAH goat using a new automatic control method (1/R control).

A total artificial heart (TAH) goat survived for 360 days on the new automatic control method (1/R control), in which the cardiac output of the TAH can be controlled through the cardiovascular center by making it function by reflecting the beta-adrenergic reaction in peripheral vascular resistance. This is thought to be the only long-term, real-time, measurable parameter by which information on the activity of the cardiovascular center can be received directly by the TAH system. In this goat, the hemodynamic parameters (RAP, AoP, and so forth) were kept within physiologic limits when control was stable, and the cardiac output was automatically increased in response to exercise, not unlike that in the natural heart. There were no abnormal blood chemical or hormone data except at end stage. Based on these results 1/R can be considered a physiologic control method for a TAH.

Animals↗