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Biomedical subjects

S Takatani

Publications and source records attributed to S Takatani.

At least 91 records · Page 5Linked to original sources

Hemodynamic regulation in total artificial heart recipients.

The right and left atrial pressures (RAP and LAP), circulating blood volume (CBV) and pump output were analyzed in 17 calves implanted with a free-diaphragm-type total artificial heart. A high RAP and increased CBV were common features in these animals, while the LAP was maintained in a nearly normal range throughout the course. Some correlation was seen between RAP, CBV and pump output, which was maintained in the range of 86.6 to 130.1 ml/min/kg. In the atrial myocardium various morphological changes were observed accompanied by thickening of the cell, which was conspicuous after one month of implantation. To improve this high venous pressure problem, an automatic controller for pusher-plate-type pumps wtih a greater sensitivity was introduced. A preliminary in vivo study using this new system is also reported.

Animals↗

Chronic nonpulsatile blood flow in an alive, awake animal 34-day survival.

Most acute studies of nonpulsatile blood flow have shown effects on systemic organs. There have been few long-term studies of the effects of nonpulsatile blood flow due to lack of an appropriate experimental model and, consequently, it is unknown whether mammalian physiology can adapt to chronic nonpulsatile blood flow. The following case report documents the effects of chronic nonpulsatile blood flow in an alive, awake animal maintained with fibrillating ventricles for a period of 34 days.

Animals↗

New crisscross-shaped port design for universal serial pumps.

The long range goal is the development of a clinically useful, implantable, skeletal muscle powered cardiac assist device (MCAD). To accomplish this goal, two criteria must be met: good anatomic fit, and antithrombogenicity. Because of the relative locations of the latissimus dorsi (LD) muscle and aorta, there are two possible port arrangements: "crisscrossed" (C design), in which the ports are crossed to anastomotic sites, and "prong" shaped (P design), in which no crossover takes place. The purpose of this paper is to determine which of these designs is best from a fluid dynamic perspective, and hence has the best possibility for low thrombogenicity. Flow visualization (FV) techniques were used during two pumping conditions in a mock loop: worst case (MCAD off) and best case (MCAD driven optimally). Results of the MCAD off tests showed that both designs required immediate actuation (for example, an IABP console). However, FV studies under optimal conditions indicated superiority of the C design, most likely due to kinetic energy-induced rotary motion combined with a minimal interport distance. It is concluded that the C design provides ideal flow dynamics, even in valveless pumps, and also has application to valved devices.

Counterpulsation↗

Baylor multipurpose circulatory support system for short- to long-term use.

A multipurpose circulatory support system has been developed as both a temporary and permanent device in total artificial hearts (TAHs) and ventricular assist devices (VADs). The multipurpose concept was derived from the development of a totally implantable electromechanical, one-piece TAH. The blood pump is pneumatically driven in short-term use and is electromechanically driven in long-term or permanent use. Both TAH and VAD versions consist of the same components, except for the actuation mechanism. The common components are a compact pumping chamber with the same configuration, a blood contacting surface biolized with gelatin, a pusher-plate, a Hexsyn rubber diaphragm (University of Akron, Akron, OH) and bovine pericardial valves. Both TAHs and VADs have 63 ml of stroke volume, and the VADs are compact compared with other available investigational device exemption devices. Currently, 1 week survival has been achieved using the electromechanical TAH and 2 week survival using the electromechanimcal VAD without anticoagulation. Results suggest that the currently developed system could be applied in varied patients as a temporary device after cardiotomy, a long-term device for bridge to transplantation, or a permanent device for end-stage heart disease.

Assisted Circulation↗

The Baylor total artificial heart. Flow visualization studies.

To analyze the flow patterns of the left blood chamber of the Baylor total artificial heart (TAH) and to evaluate influences of the inflow valve angle to the flow patterns, flow visualization studies were performed. The inflow valve angle of the left housing was changed by 20 degrees orthogonal to the inflow tube, and comparison studies of the modified and unmodified models were made. For evaluating sectional flow patterns, a laser light was used, the clear transparent housing was scanned segmentally, and flow patterns were recorded on high contrast film for measuring flow velocities. A signal was used that synchronized the timing of the camera shutter to the pusher-plate movement signal. With the modified 20 degree inflow valve direction, there were better closing characteristics of the inflow valve leaflets. At the same time, we could successfully reduce the vortex formation at the inflow port, which may cause thrombus formation. We also have improved the washout during the diastolic phase in not only the bottom area, but in the entire pumping chamber. This flow visualization setup is simple and inexpensive. It is useful not only for validation of global flow patterns, but also for validation of local flow velocities of various blood pumps.

Biomedical Engineering↗

Double chamber ventricular assist device with a roller screw linear actuator driven by left and right latissimus dorsi muscles.

A double chamber ventricular assist device (VAD) with a roller screw linear muscle actuator (RSLMA) driven by the left and right latissimus dorsi muscles was developed. The inflow port of each chamber was connected to form the compound inflow port, and the outflow ports were connected to form the compound outflow port. The advantages of this system include 1) the contraction of each muscle contributes to ejection from each ventricle into the common outflow port, thus doubling the net outflow; 2) through proper adjustment of muscle length, the preload to each muscle can be optimized to yield the maximum muscle force; 3) muscle can be stimulated at a lower rate to reduce fatigue and to optimize muscle performance; and 4) the compliance chamber needed in the implantable VAD system is not required with this system. In vitro evaluation in the mock loop with the human arm actuating the RSLMA revealed that the double chamber VAD can provide pump flows of 2-4 L/min against an afterload of 100 mmHg at a stimulation rate of 35-50 beats per minute. The power requirement for each muscle ranged from 2.5 to 3 W at a muscle stroke length of 4 cm. These results verify that the double chamber VAD with the RSLMA driven by the left and right latissimus dorsi muscles can meet the design requirements of a muscle driven VAD to assist the left heart.

Bioelectric Energy Sources↗

A unique, efficient, implantable, electromechanical, total artificial heart.

A completely implantable, one piece electromechanical total artificial heart (TAH) intended for permanent human use was developed. It consisted of left and right conically shaped pusher-plate blood pumps sandwiching a thin centerpiece with a compact, efficient electromechanical actuator. The actuator consisted of a direct current brushless motor; a planetary roller screw fit the space between the two conically shaped pusher-plates. The rotational motion of the motor was converted to the rectilinear motion of the rollerscrew to displace the left and right pusher-plates in the left master alternate mode. The diameter of the assembled TAH was 97 mm, with a central thickness of 82 mm. The overall weight was 620 g, with a displaced volume of 510 ml. The pump provided flows of 3-8 L/min with a preload of 1-15 mmHg against an afterload of 100 mmHg. The net efficiency ranged from 15% to 18%. This model showed good fit in the pericardial space of heart transplant recipients (body weight, 77 kg).

Cardiac Output↗

A biolized, compact, low noise, high performance implantable electromechanical ventricular assist system.

An implantable electromechanical ventricular assist system (VAS) intended for permanent human use was developed. It consisted of a conically shaped pumping chamber, a polyolefin (Hexsyn) rubber diaphragm attached to a pusher-plate, and a compact actuator with a direct current brushless motor and a planetary rollerscrew. The outer diameter was 97 mm, and the total thickness was 70 mm. This design was chosen to give a stroke volume of 63 ml. The device weighs 620 g, with a total volume of 360 ml. The pump can provide 8 L/min flow against 120 mmHg afterload with a preload of 10 mmHg. The inner surface of the device, including the pumping chamber and diaphragm, was made biocompatible with a dry gelatin coating. To date, two subacute (2 and 6 day) calf studies have been conducted. The pump showed reasonable anatomic fit inside the left thorax, and the entire system functioned satisfactorily in both the fill-empty mode using the Hall effect sensor signals and the conventional fixed rate mode. There were no thromboembolic complications despite no anticoagulation therapy. The system now is being endurance tested greater than 10 weeks (9 million cycles). This VAS is compact, low noise, easy to control, and has excellent biocompatibility.

Animals↗

Anatomic fit study for development of a one piece total artificial heart.

A fit study was conducted to define anatomic constraints to total artificial heart (TAH) insertion in 26 human orthotopic cardiac transplant recipients, and the parameters necessary for designing a totally implantable TAH were obtained from the excised heart. A multiadjustable fitting device was made (height, 118 mm; width, 81 mm; diameter, 97 mm), and with this model, 15 fitting and measuring studies were conducted to validate the design and demonstrate anatomic compatibility. Satisfactory fit of the contour model was observed in all cases. The model was placed through a sternotomy wound in the pericardial space. In addition to this mock-up fit study, the anatomic dimensions of the connection points to the TAH and the excised hearts also were measured. With the prototype model based on these data, a fit verification study was done in 11 recipients. Satisfactory fit in the pericardial space without compression of adjacent structures was observed in seven of 11 patients. This study suggests that the newly designed model of an anatomically and surgically practical configuration could be implanted in most patients in this population as a completely implantable cardiac prosthesis.

Anthropometry↗