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Thursday, September 21, 2006

An Artificial Heart That Doesn't Beat

A new concept for an artificial heart could solve some problems with older models--and test the idea that we don't need a pulse.

By Emily Singer

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The HeartMateII is a continuous flow cardiac assist device. Heart surgeon "Bud" Frazier and his team are working with two such devices to develop a continuous flow artificial heart. (Courtesy: Texas Heart® Institute)

Earlier this month, the first fully implantable artificial heart was approved by the Food and Drug Administration. It brings hope to patients who are near death from heart failure; yet some major problems remain with it--namely, its large size and relatively short lifespan.

A new concept for an artificial heart could solve some of those issues. But its innovative pulse-free architecture might also raise problems of its own.

Artificial hearts work by pumping deoxygenated blood from the body to the lungs. The device then pumps oxygenated blood through the body. The newly approved device, called AbioCor, made by Massachusetts-based Abiomed, uses an implanted hydraulic pumping system to simulate a natural heart beat. But an alternative design, conceived by O.H. "Bud" Frazier, a prominent heart surgeon and pioneer in the development of cardiac devices at the Texas Heart Institute in Houston, pumps blood through the body continuously, rather than with the periodic beat of the normal heart.

Pumps that work on this principle, known as continuous flow pumps, are already in clinical use as part of "ventricular assist devices," which are implanted into patients with some remaining heart function to help circulate blood through the body. (Artificial hearts replace the heart entirely.)

"Continuous flow pumps are like little turbo machines," says Tim Baldwin, program director of the advanced technologies and surgery branch of the National Heart, Lung and Blood Institute in Bethesda MD. "They are more durable and allow you to make smaller devices."

With Frazier's continuous flow design for an entirely artificial heart, a severely damaged heart is removed and replaced with two rotor-based pumps that continually cycle blood through the body, completely taking over the function of the heart.

In preliminary experiments conducted over the last two years, Frazier and his team have implanted pairs of commercially available ventricular-assist devices into calves that had their hearts removed. The researchers say the devices were able to pump blood and respond to the animals' needs based on their activities. "You put this in cattle and they stand up and moo and eat and wonder why everyone is looking at them so weird," says William Cohn, a collaborator on the research and director of minimally invasive surgical technology at the Texas Heart Institute. "You see a cow wagging his tail and you say, wow, this is the future of the artificial heart."

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Comments

  • Best of Both Worlds
    wdilwort on 09/21/2006 at 3:04 PM
    Posts:
    1
    I would agree that the axial pump is the most reliable but could they not put a feed-back circuit from the output of the pump back to the imput of he pump.  In this "pipe" insert a valve that would close say 60 time a minute.  When the valve is closed blood would be forced through the body and when it is open blood would take the bypass back to the inpt of the pump.  The pump would stay very reliable and the body would see a pulsed blood flow.

    The value would be controled by a circuit with a default setting of say 60 pulses a minute.  This could be over road by a senser monitoring the lungs rate or even a oxygen sensor in the bood stream.  

    Well, I guess I just made it more complicated and thus more problem prone to problems but it seems like a simple way of getting the best of both worlds.
    Rate this comment: 12345
  • EMT scare
    deirdrebeth on 09/25/2006 at 1:45 PM
    Posts:
    25
    I am very impressed with the research on this, and will look forward to reading more on the extended trials...but before this is ever implanted in someone who is going to walk out of the hospital there has to be some way to permanently "mark" the patient as having no pulse.  Can you image what would happen if an EMT (or insert-medical-personel-here) came across an unconscious patient with no pulse...
    Rate this comment: 12345
    • Re: EMT scare
      kitk on 09/27/2006 at 12:57 AM
      Posts:
      50
      Avg Rating:
      3/5
      I recall the early days of such turbo pumps--then imagined largely as booster for weak hearts. My one worry,,, well, one of them,,, is that not much study is reported on what the turbo blades do to blood cells. Current heart bypass pumps are not used for long periods in part because of damage they do to fragile blood cells--in other words, our hearts are made this way for a reason.
        Also, the heart is more than a dumb pump. It produces regulatory chemicals, it is an organ just like any other, with multiple functions. I would advise some research into the hearts--aortic arches--of insects. They are like stacked simple pumps, and seem mechanically simple. If an artificial version could be fitted into a failing human heart, leaving most of the human heart, it could possibly perform all needed functions.
      Rate this comment: 12345
  • concerns and ideas
    praxius on 05/08/2007 at 2:57 PM
    Posts:
    1
    I've done thought experiments of pulseless blood-flow using nanobots, and utilizing their swarm nature -- swimming like a school of fish carrying blood with them; of course these devices don't exist yet, but give it about 15 years. From this it was my feeling that a pulseless flow of blood would not keep blood vessels elastic, making them more susceptible to damage. And getting fluid between the cells would prove more difficult without an extra bit of force to "get in there". Would that contribute to clogging of an already inefficient lymphatic system?

    Why not build into the device a "fluid capacitor" that builds a little pressure in a balloon-like structure then discharges for the pulse effect? Blood would continuously flow but an extra "push" every 5 to 10 seconds or so would emulate the heart beat giving the body the desired effects of a pulse.

    John
    Rate this comment: 12345
  • Chemical Response
    aldebaralph on 06/12/2007 at 10:44 AM
    Posts:
    1
    Avg Rating:
    3/5
    I`m not a doctor, or someone with vast knowledge in the theme, but I think it`s clearly important to consider the role of chemistry in this problem. while every labotarory is concerned about the physcis part, refering to replace a "pump" no one is considering that this "pump" doesn`t only obey to mechanical/physical stimulation, such as running, they are ignoring situations of danger, imagine someone who is in mortal danger, and his body starts producing adrenaline, the natural heats respond to this stimule, pumping faster the blood, but how can an artificial heart, axial, nanobots, or any artificial heart designed until today would respond to this if this artifial doesnt respond to this stimulation? And the thing is, how this is going to affect the patient in his response to the situation?
    Rate this comment: 12345
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