Development of totally implantable pulsatile biventricular assist device.

Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, Korea.
Artificial Organs (Impact Factor: 1.96). 02/2003; 27(1):119-23. DOI: 10.1046/j.1525-1594.2003.07177.x
Source: PubMed

ABSTRACT Approximately 10% to 15% of all patients implanted with left ventricular assist devices (LVADs) have required right heart support with another device. The necessity of aggressive biventricular support has already been proposed. Therefore, the totally implantable biventricular assist device (BVAD) was developed. The width of the BVAD main body was 87 mm, the thickness 67 mm, and the height 106 mm, while the weight was 785 g. The automatic control algorithm was developed to prevent lung edema and atrial rupture.

  • [Show abstract] [Hide abstract]
    ABSTRACT: The optimal treatment option for end stage heart failure is transplantation; however, the shortage of donor organs necessitates alternative treatment strategies such as mechanical circulatory assistance. Ventricular assist devices (VADs) are employed to support these cases while awaiting cardiac recovery or transplantation, or in some cases as destination therapy. While left ventricular assist device (LVAD) therapy alone is effective in many instances, up to 50% of LVAD recipients demonstrate clinically significant postoperative right ventricular failure and potentially need a biventricular assist device (BiVAD). In these cases, the BiVAD can effectively support both sides of the failing heart. This article presents a technical review of BiVADs, both clinically applied and under development. The BiVADs which have been used clinically are predominantly first generation, pulsatile, and paracorporeal systems that are bulky and prone to device failure, thrombus formation, and infection. While they have saved many lives, they generally necessitate a large external pneumatic driver which inhibits normal movement and quality of life for many patients. In an attempt to alleviate these issues, several smaller, implantable second and third generation devices that use either immersed mechanical blood bearings or hydrodynamic/magnetic levitation systems to support a rotating impeller are under development or in the early stages of clinical use. Although these rotary devices may offer a longer term, completely implantable option for patients with biventricular failure, their control strategies need to be refined to compete with the inherent volume balancing ability of the first generation devices. The BiVAD systems potentially offer an improved quality of life to patients with total heart failure, and thus a viable alternative to heart transplantation is anticipated with continued development.
    Annals of Biomedical Engineering 09/2011; 39(9):2313-28. · 3.23 Impact Factor
  • Artificial Organs 07/2013; 37(7):587-90. · 1.96 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The complexity of the brain and the membranous blood-brain barrier (BBB) has proved to be a significant limitation to the systemic delivery of pharmaceuticals to the brain rendering them sub-therapeutic and ineffective in the treatment of neurological diseases. Apart from this, lack of innovation in product development to counteract the problem is also a major contributing factor to a poor therapeutic outcome. Various innovative strategies show potential in treating some of the neurological disorders; however drug delivery remains the most popular. To attain therapeutic drug levels in the central nervous system (CNS), large, intolerable systemic doses are generally administered. The success of maintenance therapy in many neurological diseases depends on a number of variables, including the constant release of neurotherapeutics, a reduction in the dosing frequency, a greater antipsychotic drug bioavailability and ultimately improved patient compliance, many of which is not achievable by conventional oral or parenteral formulations. This article reviews the therapeutic implantable polymeric and transdermal devices employed in an attempt to effectively achieve therapeutic quantities of drug across the BBB over a prolonged period, to improve patient disease prognosis.

Full-text (2 Sources)

Available from
May 30, 2014