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Biomedical subjects

P D Diegel

Publications and source records attributed to P D Diegel.

9 recordsLinked to original sources

A moving-actuator type electromechanical total artificial heart--Part I: Linear type and mock circulation experiments.

A new type of motor-driven total artificial heart system with a moving-actuator mechanism has been developed. The prototype system consists of a brushless dc motor inside of a rolling-cylinder, two arc-shaped pusher-plates and two polyurethane sacs. The moving-actuator type electromechanical pump has structural advantages of small size and light weight, as compared to other reported motor-driven pumps with fixed-actuator mechanisms. The results of the mock circulation tests are reported in this paper with a cardiac output of 9 L/min at an aortic pressure of 120 mmHg and a heart rate of 120 bpm. The fulfillment of the basic control requirements of the artificial heart was also confirmed, i.e., preload sensitive and afterload insensitive cardiac output response and balanced right and left ventricular outputs.

Algorithms↗

A moving-actuator type electromechanical total artificial heart--Part II: Circular type and animal experiment.

A new type of electromechanical total artificial heart (TAH) based on circular rolling-cylinder mechanism was developed to overcome critical problems in motor-driven artificial hearts such as large size and difficulties in fitting the heart to atrial remnants and arterial vessels. Its performance and reliability were evaluated in mock circulation and in an animal implant experiment. The total weight and volume of the pump is 650 g and 600 mL, respectively. This new pump was implanted in a calf for total heart replacement and 96 h of survival was achieved. The whole system, including pump, controller, and control algorithm performed well enough to improve the prospect of eventual clinical application of our TAH system.

Animals↗

Development of a biocompatible hermetically sealed electrical feedthrough.

A new biocompatible hermetically sealed electric wire feedthrough has been developed for use in a totally implantable artificial heart (TAH) and ventricular assist device (VAD). This feedthrough allows electric current to pass through a rigid polyurethane (Isoplast 301, Dow Chemical U.S.A., Midland, MI) housing wall. The implantable housing is exposed externally to tissue and body fluids and is filled with low viscosity silicone oil (decamethyltetrasiloxane) which acts as a hydraulic fluid. The feedthrough prevents fluid transfer which caused early prototype devices to fail. The feedthrough consists of external and internal wires insulated with soft segmented polyurethane (Biomer, Ethicon, Somerville, NJ) and soldered to opposite ends of a conductive pin. The pin and the wire connections are encapsulated in Biomer, forming a leak-free barrier between the housing wall and the wire insulation. The pin soldered between the two wires prevents leakage from between the strands and the insulation.

Animals↗

Initial effect of collarless stem stiffness on femoral bone strain.

Stress shielding resulting from a stiffness mismatch between bone and femoral prosthesis stems (leading to bone resorption in the proximal femur) is believed to contribute to failure in total hip arthroplasty. In this study, strains were measured under compressive femoral head loads both in the intact femur and after implanting first a collarless steel stem and then a geometrically identical fiber-reinforced polymer composite stem 64% less stiff. Decreasing stem stiffness would be expected increase load transfer from the stem to the proximal medial femur, decreasing the degree of stress shielding. The authors found that proximal medial bone strains were significantly lower with either the steel or composite stem implanted than in the intact case. However, there were no significant differences in strain patterns between the steel and composite stem cases. This apparent insensitivity to prosthesis stiffness may result from factors related to implant geometry and fit.

Adult↗

Electrohydraulic ventricular assist device development.

An electrohydraulic ventricular assist device has been developed. An axial flow pump driven by a brushless DC motor provides actuation. Energy is supplied by internal Ni/Cd batteries and by external Ag/Zn batteries, both rechargeable. Electromagnetic induction is used to pass energy through the skin with a transcutaneous energy transfer (TET) system. Physiologic control, battery management, motor commutation, and communication functions are performed by a surface mount internal controller. An infrared data link within the TET coils provides bidirectional communication between the external and internal controllers. A computer model was developed to predict system performance. The dimensions are 180 mm x 116 mm x 40 mm. An in vitro system pumped 5.7 L/min at 10 mmHg inflow and 100 mmHg outflow pressure. The internal battery can provide the projected energy requirements for 40 min after 540 charge/discharge cycles, and the external battery is capable of 4 hr of operation after 150 cycles. The TET system can deliver 60 W of power and exceeds 80% efficiency between 15 and 30 W. The device configuration is based on human cadaver and intraoperative fit trials. The device is being modified for calf implantation by redirecting the blood ports, increasing the output, and incorporating the internal controller in the unified device base.

Animals↗

A blood pump with an interatrial shunt for use as an electrohydraulic total artificial heart.

A recently designed blood pump subsystem for the completely implantable electrohydraulic total artificial heart (EHTAH) has been developed and is under evaluation. The subsystem consists of joined left and right ventricles, atrial cuffs with an interatrial shunt (IAS), and two outflow grafts. The ventricles were developed to fit within the pericardial space based on the results of anatomic fit trials. An optimized configuration for animal use, which was adaptable for human use with minimal modification, was identified. The core dimensions of the ventricles with an energy converter are approximately 10 x 11 x 7 cm. Maximum output and stroke volume are 9.2 L/min and 81 ml, respectively. The IAS is used to balance the volumetrically coupled EHTAH, and is made by forming an orifice in the common septum of the left and right atrial cuffs. Performance and durability of the IAS were examined in animal experiments for up to 9 days. The diameter of the IAS was 3.4-5.5 mm, and the left-right atrial pressure difference ranged from 2 to 10 mmHg, with 0.57-1.48 L/min of theoretically calculated shunt flow. No evidence of thrombus formation was found in or around the IAS at autopsy. The entire EHTAH system with a new blood pump is being assembled for long-term animal studies.

Animals↗

Development of a totally implantable artificial heart.

The first generation of an integrated, totally implantable electrohydraulic total artificial heart was designed for long-term cardiac replacement. The system consists of an elliptical blood pump with an interatrial shunt, Medtronic-Hall 27 mm and 25 mm inflow and outflow valves, respectively, an energy converter consisting of an axial-flow, hydraulic pump driven by a brushless DC motor, and an electronics system with transcutaneous energy transmission and telemetry. Energy is supplied by internal nickel-cadmium rechargeable batteries that supply power for 20 min and external silver-zinc batteries that are designed to supply energy to run the system for 5 hr. The blood pump consists of a single layer diaphragm cast from Biolon, with joined right and left ventricles sharing a common base. The dynamic stroke volume is 84 ml, and maximum cardiac output is 9.2 L/min at a heart rate of 110 beats/min on the mock circulation. A 4.3 mm diameter interatrial shunt is used to balance the volumetrically coupled ventricles. The energy converter pumps hydraulic fluid alternately between ventricles, with controlled, active filling in one ventricle during the systolic phase of the other ventricle. Internal or external controllers adjust the heart rate and motor speed to maintain normal atrial filling pressures and full stroke. Electromagnetic induction is used to transfer energy through the skin and a bidirectional infrared data link incorporated within the transcutaneous energy transmission coils is used to transmit information. The entire system is being assembled and refined for long-term animal implant studies.

Algorithms↗

Preliminary in vitro evaluation of the first neonatal total artificial heart.

A neonatal total artificial heart (TAH), used as a bridging device, can offer circulatory support for patients suffering from otherwise insupportable and inoperable congenital cardiac defects. The choice of the 7.0 ml stroke volume (SV) was based on reported studies on cardiac output (CO) requirements and maximum dimensions of a neonate size TAH. This SV will allow a bridging period of up to 10 weeks in the growing neonate. For in vitro testing purposes, "high-profile" ball valves of in-house design (10-13 mm ID) were used. Redesign of the existing in vitro testing systems, including mock circulation and high-flow blood reservoirs, was required for the smaller device. Mock circulation studies (rates 90-160 BPM, full-fill and ejection modes) showed adequate device performance, with CO values well above the reported marginal output value of 139 ml/kg/min.

Heart Defects, Congenital↗

Electrohydraulic ventricular assist device development.

A 64 ml (effective stroke volume) in vitro electrohydraulic ventricular assist device (VAD) prototype has been built. The energy converter is an axial flow pump driven by a brushless direct current (DC) motor. Systole begins as silicone oil is pumped from the volume displacement chamber (VDC) into the ventricle, displacing the flexing diaphragm separating the oil and the blood. In diastole, the motor reverses, providing active filling by pumping oil from the ventricle into the VDC. The surface mount electronic internal controller provides motor commutator, energy management, telemetry, and physiologic control functions. Energy is supplied externally by either a 12 V DC power supply or a 12 V DC rechargeable battery and is transmitted through the skin by a transcutaneous energy transformer (TET). Energy can also be supplied by a 12 V DC rechargeable internal battery. Bidirectional infrared telemetry is used to transmit information between the internal and external controllers.

Blood Pressure↗