minimally invasive compressional assist device
DESCRIPTION
Minimally Invasive Compressional Assist Device. TRIDORE MEDICAL Erika Brown, Caryl Brzymialkiewicz, and Mark Carlson. Advisor: Dr. Drew Gaffney, M.D. Professor of Medicine, VUMC. Project Definition. To design a cardiac assist device, implantable with minimally invasive surgery that aids in - PowerPoint PPT PresentationTRANSCRIPT
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Minimally InvasiveCompressional Assist Device
Advisor: Dr. Drew Gaffney, M.D.Professor of Medicine, VUMC
TRIDORE MEDICALErika Brown, Caryl Brzymialkiewicz, and Mark Carlson
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Project Definition
To design a cardiac assist device, implantablewith minimally invasive surgery that aids inpumping, and in the case of a hypertrophic
heart, also improves function over time.
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Cardiac Indications
• Systolic Ejection Fraction= Stroke volume _
End Diastolic Volume• Hypertrophic heart
(e.g. Chagas disease)– sarcomeres expand and
lose contraction efficiency
– self-perpetuating positive feedback system Frank-Starling Curve
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What is currently available?OPTIONS• Various drug treatments
(ie - digitalis)(1776)• Intra-Aortic Balloon Pumping (1961)• Extracorporeal assist devices (1963)• Heart transplants (1967)• Total Artificial Hearts
(1969-Cooley, 1982-DeVries)• Bridge-to-Transplant Implantable
Ventricular Assist Devices (1978)• Batista’s wedge resectioning surgery
(PLV) (1994)
PROBLEMS• Invasiveness
– Cost– Mortality– Discomfort
• Length of use• Aid in pumping or healing, but
not both• Recipient limitations
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Project Overview
• Brainstorming until end of January• Research until late February• In vitro model design and testing through
mid-to-late March• Evaluation of in vitro results and adaptation
into a prototype clinical design by end of the semester
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What have we done so far?• Password protected web page• Patent search• Located pertinent cardiology and instrumentation resources• In-depth review of current technologies• Brainstormed wants and needs, possible design options, and potential
problems to create a decision matrix• Developed rough sketch of design concept• Started brainstorming problems and solutions for various
components of the design• Began biomaterials research• Began economic and safety analyses
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Decision Matrix
Design Sim
plic
ityW E
stim
ated
Rel
ativ
e Lo
w C
ost
W Saf
ety
(fai
lure
mod
es)
W Low
Hea
t Cre
atio
n
W Eas
e of
Impl
anta
tion
W Eas
e of
Exp
lant
atio
n
W Eas
e of
Clo
sure
W Eas
e in
Siz
ing
W Eas
e in
Alig
nmen
t
W Sim
plic
ity o
f Pre
ssur
e A
djus
tmen
t
W Ris
k fo
r In
fect
ion
W Effe
ctiv
enes
s
W TOTALAttached 2 Bladder System with fabric shell 10 5 0 3 10 5 9 4 10 4 10 3 8 4 7 2 9 4 6 3 7 3 8 5 367Adjustible 2 Bladder System with fabric shell 9 5 0 3 10 5 9 4 10 4 10 3 8 4 7 2 9 4 6 3 7 3 9 5 367Finger Bladder System with fabric shell 10 5 0 3 10 5 9 4 10 4 10 3 8 4 7 2 5 4 6 3 7 3 6 5 341Spiral Bladder System with fabric shell 10 5 0 3 10 5 9 4 10 4 10 3 8 4 7 2 8 4 6 3 7 3 3 5 338Adjustible 2 Bladder System with spring reinforced fabric shell 8 5 0 3 9 5 9 4 9 4 9 3 8 4 7 2 7 4 6 3 7 3 7 5 332Attached 2 Bladder System with spring reinforced fabric shell 9 5 0 3 9 5 9 4 9 4 9 3 8 4 7 2 6 4 6 3 7 3 6 5 328Adjustible 2 Bladder System with hard shell 7 5 0 3 8 5 9 4 7 4 6 3 8 4 6 2 8 4 6 3 7 3 8 5 312Attached 2 Bladder System with hard shell 8 5 0 3 8 5 9 4 7 4 6 3 8 4 6 2 7 4 6 3 7 3 7 5 308Finger Bladder System with hard shell 9 5 0 3 8 5 9 4 7 4 6 3 8 4 6 2 5 4 6 3 7 3 6 5 300Spiral Bladder System with hard shell 9 5 0 3 8 5 9 4 7 4 6 3 8 4 6 2 8 4 6 3 7 3 3 5 297Attached Multi-Bladder System with orange peel 6 5 0 3 9 5 9 4 6 4 6 3 4 4 7 2 5 4 6 3 7 3 7 5 277Wide Band Mechanical Design 10 5 0 3 6 5 7 4 5 4 8 3 5 4 8 2 10 4 4 3 5 3 3 5 270Mechanical Finger Design with pull string 6 5 0 3 6 5 7 4 5 4 8 3 3 4 5 2 5 4 4 3 5 3 5 5 226Roller Bar System 5 5 0 3 4 5 4 4 6 4 8 3 3 4 5 2 9 4 4 3 5 3 3 5 209Mechanical Finger Design with Driving Motor 5 5 0 3 5 5 5 4 5 4 8 3 3 4 5 2 5 4 4 3 5 3 5 5 208
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What are we currently doing?
• Working on a solid design for our in vitro model
• Developing tests for the model
• Trying to acquire components for testing and analysis
• Finishing economic and safety analyses
• Trying to set up viewing of cardiac surgery
MICAD Preliminary DesignNOTE: Trigger, pumping, and power
components are extracorporeal
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Current questions...• What is the relationship between pressures applied on the outside of
the heart and increased blood pressure?• How can we ensure a physiologically accurate inflation of the
bladders?• Over a matter of weeks, how effective would a drawstring be in
holding the device in place?• Are pericardial sutures a realistic option for increasing device
stability?• What sorts of reciprocating pumps are currently available?• What fabric can offer the most support while retaining flexibility for
implantation?
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What will we do next?
• Research current pumping and triggering options
• Acquire in vitro test and analysis equipment• Calculate necessary design parameters• Choose materials and actually construct an in
vitro model• Research effects of applied pressures on
healing hypertrophism
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Resources
• Committee to Evaluate the Artificial Heart Program of the NHLBI (1991) The Artificial Heart: Problems, Policies, and Patients. National Academy Press: Washington, DC.
• Sherwood, L. (1997) Human Physiology: From Cells to Systems, 3rd Ed. Wadsworth Publishing Co.: Belmont, CA.
• Quall, S.J., ed. (1993) Cardiac Mechanical Assistance Beyond Balloon Pumping. Mosby Year-Book, Inc.: St. Louis, MO.