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Copyright of Bearing is the property of Bearing Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The goal of this study was to evaluate the effect of extracorporeal membrane oxygenation (ECMO) on mortality in patients with cardiogenic shock excluding Impella and IABP use. Method: The large Nationwide Inpatient Sample (NIS) database was utilized to study any association between the use of ECMO in adults over the age of 18 and mortality and complications with a diagnosis of cardiogenic shocks. Results: ICD-10 codes for ECMO and cardiogenic shock for the available years 2016–2020 were utilized. A total of 796,585 (age 66.5 ± 14.4) patients had a diagnosis of cardiogenic shock excluding Impella. Of these patients, 13,160 (age 53.7 ± 15.4) were treated with ECMO without IABP use. Total inpatient mortality without any device was 32.7%. It was 47.9% with ECMO. In a multivariate analysis adjusting for 47 variables such as age, gender, race, lactic acidosis, three-vessel intervention, left main myocardial infarction, cardiomyopathy, systolic heart failure, acute ST-elevation myocardial infarction, peripheral vascular disease, chronic renal disease, etc., ECMO utilization remained highly associated with mortality (OR: 1.78, CI: 1.6–1.9, p < 0.001). Evaluating teaching hospitals only revealed similar findings. Major complications were also high in the ECMO cohort. Conclusions: In patients with cardiogenic shock, the use of ECMO was associated with the high in-hospital mortality regardless of comorbid condition, high-risk futures, or type of hospital. [ABSTRACT FROM AUTHOR]

Copyright of Actualités Pharmaceutiques is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

With gradual maturity of surgical technique of heart transplantation, extensive use of immunosuppressants and the improvement of organ distribution system, the shortage of donor heart has become a bottleneck issue restricting the development of heart transplantation in clinical practice. How to expand the donor pool for heart transplantation remains to be urgently solved. In recent years, with the development of science and technology and the application of new technology, groundbreaking progresses have been made on how to expand the donor pool for heart transplantation within the transplantation community. Multiple research results have been gradually translated into clinical practice, driving the development of heart transplantation in clinical settings. In this article, the latest technologies and strategies to expand the donor pool for heart transplantation were reviewed, the roles of organ preservation technology, use of marginal donor heart, xenotransplantation, artificial heart and bioartificial heart in alleviating the shortage of donor heart were investigated, and existing challenges and future directions to expand the donor pool for heart transplantation were summarized, aiming to provide reference for subsequent development of heart transplantation in clinical practice. [ABSTRACT FROM AUTHOR]

The main limitation of allotransplantation and in particular heart transplantation is the insufficient supply of donor organs. As alternative strategies to heart transplantation, stem cells opened the way of regenerative medicine in early 2000. While new biotechnologies tried to minimize side effects due to hemocompatibility in artificial hearts, progress in xenotransplantation allowed in 2022 to realize the first pig-to-human heart transplant on a compassionate use basis. This xenotransplantation has been successful thanks to genetically modified pigs using the CRISPR-Cas9 technology. Indeed, gene editing allowed modifications of immune responses and thrombotic potential to modulate graft and systemic reaction. Academic research and preclinical studies of xenogeneic tissues already used in clinic such as bioprosthesis valve and of new xenotransplantation options will be necessary to evaluate immune-thrombosis and organ/vascular damages more deeply to make this hope of xenotransplantation a clinical reality. Stem cells, artificial heart and xenotransplantation are all in line to overcome the lack of donor hearts. Combination of stem cell approaches and/or xenogeneic tissue and/or artificial organs are probably part of the research objectives to make these projects real in the short term. [ABSTRACT FROM AUTHOR]

Copyright of Zeitschrift für Herz-, Thorax- und Gefaesschirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Heart transplantation is one of the most effective strategies to treat end-stage heart failure. Multiple challenges, such as difficulty in preservation of heart allograft, rejection and postoperative complications, emerge in heart allotransplantation. After decades of research and practice, most problems have been resolved. Nevertheless, the shortage of donor organs has become increasingly prominent. To alleviate the shortage of donor organs, artificial heart and heart xenotransplantation have captivated attention, and obtained significant progress in recent years. The application of artificial heart in clinical practice has significantly enhanced the survival rate of patients with end-stage heart failure, which is expected to become the standard treatment for end-stage heart failure. Heart xenotransplantation still faces many challenges, which is still far from clinical application. In this article, the history of heart transplantation, development of heart allotransplantation, use of artificial heart and research progress on heart xenotransplantation were reviewed, and the future development direction of heart transplantation was predicted. [ABSTRACT FROM AUTHOR]

Introduction: Titanium (Ti) and Ti-based alloy materials are commonly used to develop artificial hearts. To prevent bacterial infections and thrombus in patients with implanted artificial hearts, long-term prophylactic antibiotics and anti-thrombotic drugs are required, and this may lead to health complications. Therefore, the development of optimized antibacterial and antifouling surfaces for Ti-based substrate is especially critical when designing artificial heart implants.Methods: In this study, polydopamine and poly-(sulfobetaine methacrylate) polymers were co-deposited to form a coating on the surface of Ti substrate, a process initiated by Cu2+ metal ions. The mechanism for the fabrication of the coating was investigated by coating thickness measurements as well as Ultraviolet–visible and X-ray Photoelectron (XPS) spectroscopy. Characterization of the coating was observed by optical imaging, scanning electron microscope (SEM), XPS, atomic force microscope (AFM), water contact angle and film thickness. In addition, antibacterial property of the coating was tested using Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) as model strains, while the material biocompatibility was assessed by the antiplatelet adhesion test using platelet-rich plasma and in vitro cytotoxicity tests using human umbilical vein endothelial cells and red blood cells.Results and discussion: Optical imaging, SEM, XPS, AFM, water contact angle, and film thickness tests demonstrated that the coating was successfully deposited on the Ti substrate surface. The biocompatibility and antibacterial assays showed that the developed surface holds great potential for improving the antibacterial and antiplatelet adhesion properties of Ti-based heart implants.

A total artificial heart (TAH) represents a challenge in medical science to provide a survival perspective for patients with severe cardiac problems. Although cardiac transplantation represents the optimal therapeutic solution for end-stage heart failure, its application is limited by organ shortages. However, innovative technologies that can fit the operation and constraints of a physical heart are now under experimentation, making the target of a reliable and minimally invasive TAH much closer. The electromagnetic devices involved in system supply and actuation could potentially improve patient quality of life and expectancy. The purpose of this paper is to provide an overview of the operating principle, ratings, and key performance of the main electromagnetic components, with a particular focus on actuators that emulate the pumping effect of the heart ventricles. Linear oscillating actuators are very promising for their compactness and straightforward integration; therefore, an exhaustive overview considering both the single and the dual-mover configurations is worth being carried out. Taking a cue on the projects under development and after a detailed literature investigation, the pros and cons of the different solutions are discussed with the purpose of providing a critical analysis of the state-of-the-art. [ABSTRACT FROM AUTHOR]

At present, heart transplantation is the most effective treatment for end-stage heart failure. Nevertheless, the shortage of donors is becoming an increasingly severe challenge. In recent years, rapid development of mechanical circulatory support technologies has provided multiple therapeutic options for patients with end-stage heart failure. As an important mechanical circulatory support device, ventricular assist device (VAD) are divided into durable VAD (dVAD) and temporary VAD (tVAD) according to the duration of assistance. dVAD shows application potential in bridging heart transplantation, destination therapy and bridge to decision. With technological progress and experience accumulation in clinical application, VAD is evolving towards the direction of more biocompatible, lighter, more bionic and intelligent. In this article, the development of VAD, application status at home and abroad and the overall application of VAD in our hospital were reviewed, aiming to provide reference for promoting the clinical application of VAD in China. [ABSTRACT FROM AUTHOR]

The usability assessment of a pacemaker is a complex task where the dedicated programmer for testing programmed algorithms is necessary. This paper provides the outcomes of development and complex testing of the artificial cardiac system to evaluate the pacemaker's functionality. In this work, we used the modular laboratory platform ELVIS II and created graphical user interface in LabVIEW programming environment. The electrical model of the heart allows signals generation (right atrium, right ventricle) and the monitoring of the stimulation pulses. The LabVIEW user interface allows to set the parameters of the generated signals and the simulation of the cardiac rhythm disorders as well as the monitoring and visualization of the pacemaker behavior in real-time. The results demonstrate the capability of proposed system to evaluate the paced and sensed pulses. The proposed solution allows the scientists to test the behavior of any cardiac pacemaker for its pre-programmed settings and pacing mode. In addition, the proposed system can simulate various disorders and test cardiac pacemakers in different working modes. [ABSTRACT FROM AUTHOR]

In the heart failure patient spectrum, there is a group that has been called advanced heart failure. This group of patients is characterized by remaining in functional class III-IV and/or by recurrent hospitalizations despite maximum doses of neuro-hormonal management (by the way, the maximum doses in these patients are usually much lower than the target doses since their tolerance to medication decreases as the disease progresses) and interventional strategies when applicable (this is resynchronization-type stimulation devices, wireless monitoring sistemas (cardioMEMS), correction of valve disease, among others). In this group of patients, one of two paths must be chosen: palliative management or advanced therapies. Both paths are also accompanied by continuing cardinal medication as far as possible; day hospitalization with inotropy, intravenous diuretics, iron replacement; cardiac rehabilitation and multidisciplinary support. In patients who decide on advanced therapies, the first option is transplantation, however, not all will have access to an organ, for these patients the alternative of left ventricular assistance has been created. In the following pages we will delve into the classification, operation, indications, contraindications of said devices and what has been their evolution in the hands of research studies that support their use, as well as what is the current evidence regarding these devices. In a tangential way, the artificial heart will also be discussed, with regards to its structure, operation and the available clinical evidence. Resumen: En el espectro de los pacientes con falla cardíaca, hay un grupo que se ha denominado falla cardíaca avanzada, este grupo de pacientes se caracteriza por permanecer en clase funcional III-IV y/o por hospitalizaciones recurrentes a pesar de dosis máximas de manejo neuro-hormonal (dicho sea de paso, las dosis máximas en estos pacientes suelen ser bastante menores a las dosis metas pues su tolerancia a los medicamentos disminuye a medida que progresa la enfermedad) y estrategias de intervencionismo cuando aplique (esto es, dispositivos de estimulación tipo resincronización, sistemas de monitoreo inalámbricos (cardioMEMS), corrección de valvulopatías, entre otras). En este grupo de pacientes se toma la decisión de elegir uno de dos caminos: manejo paliativo o terapias avanzadas. Ambos caminos además se acompañan de continuar la medicación cardinal en la medida de lo posible; hospitalización día con inotropia, diuréticos intravenosos, reposición de hierro; rehabilitación cardíaca y apoyo multidisciplinario. En los pacientes que se decide terapias avanzadas la primera opción es el trasplante, sin embargo, no todos tendrán la oportunidad de poder acceder a un órgano. Para estos pacientes se ha creado la alternativa de asistencia ventricular izquierda. En las siguientes páginas ahondaremos en la clasificación, el funcionamiento, las indicaciones, las contraindicaciones y cuál ha sido la evolución de la terapia de asistencia ventricular de la mano de los estudios de investigación que avalan su uso, así como cuál es la evidencia actual de dichos dispositivos. De forma tangencial también se hablará del corazón artificial en cuanto a su estructura, funcionamiento y la evidencia clínica disponible.

Copyright of Revista Médica Clínica Las Condes is the property of Editorial Sanchez y Barcelo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study presents the development of adaptive control algorithm based on backstepping methodology for magnetic suspension of rotating impeller for artificial heart pump subjected to external disturbance. The magnetic bearing system for pump impeller consists of two pairs of magnetic coils, one pair at each end of the impeller. These coils are injected by the required control currents to produce the necessary magnetic field for correctly suspending the axial motions of impeller in both horizontal and vertical planes. The adaptive backstepping control algorithm has been established by following a rigorous Lyapunov-based stability analysis, to prove the asymptotic convergence of errors in the presence of unknown external uncertainty. The setting of design parameters for the adaptive controller is another issue which has been solved by suggesting particle swarm optimization to tune the design parameters of adaptive controller toward optimal performance. The computer simulation showed that the optimal adaptive controller could successfully and quickly suspend the impeller for both regulation and tracking scenarios irrespective to all initial deviations of rotating shaft under exerted disturbance. Also, the developed adaptive laws of proposed adaptive controller could estimate the uncertainty without drift, which ensures the asymptotic convergence of errors. [ABSTRACT FROM AUTHOR]

A total artificial heart (TAH) represents a challenge in medical science to provide a survival perspective for patients with severe cardiac problems. Although cardiac transplantation represents the optimal therapeutic solution for end-stage heart failure, its application is limited by organ shortages. However, innovative technologies that can fit the operation and constraints of a physical heart are now under experimentation, making the target of a reliable and minimally invasive TAH much closer. The electromagnetic devices involved in system supply and actuation could potentially improve patient quality of life and expectancy. The purpose of this paper is to provide an overview of the operating principle, ratings, and key performance of the main electromagnetic components, with a particular focus on actuators that emulate the pumping effect of the heart ventricles. Linear oscillating actuators are very promising for their compactness and straightforward integration; therefore, an exhaustive overview considering both the single and the dual-mover configurations is worth being carried out. Taking a cue on the projects under development and after a detailed literature investigation, the pros and cons of the different solutions are discussed with the purpose of providing a critical analysis of the state-of-the-art.

Introduction: End-stage heart failure (HF) is a condition whose only successful long-term treatment, with a survival of more than 10 years, is heart transplantation. However, limited organ availability and the progressive increase in the number of patients with advanced HF have served as an impetus for the development of implantable mechanical assistive devices., Aim: To provide an overview of postoperative management and nursing care after the implementation of a Total Artificial Heart (TAH)., Methods: A scoping review was carried out by consulting the PUBMED, CINAHL, and COCHRANE databases. From all the documents located, information was extracted on the date of publication, country of publication, type of study, and results of interest to answer the research question. In addition, the degree of recommendation was identified., Results: Twenty-three documents were included in the scoping review. Results were classified in relation to: 1) description of the CAT SynCardia®; 2) nursing care in the immediate postoperative period (management of the device and management of hematological, infectious, nephrological, nutritional complications, related to immobilization, sleep-rest disturbances, psychological disorders, and patient and family education); and 3) follow-up at home., Conclusions: The complexity of implantation of the TAH, the multiple related complications that can arise during this process, both in the immediate post-operative and late, require a standardised and multidisciplinary management. The absence of standardised protocols raises the need for future studies to measure the effectiveness of care in patients with TAH. A multidisciplinary approach is crucial. Nurses must acquire autonomy and involvement in decision-making and develop competencies to address the patient's and family's physiological and psychosocial needs., (Copyright © 2023 The Author(s). Published by Elsevier España S.L.U. All rights reserved.)

Although DE has been reported 20 years ago, the scientific understandings of dielectric elastomer still remain unclear. The most accepted theory still cannot explain some experimental results. The Wu-Zhang-Wang model which can explain those results is proposed in this work. Under the guidance of this model, a polyphosphazene with 80% pre-strain-free actuated strain is synthesized. The all-soft artificial heart based on this polyphosphazene works exactly like the natural heart and may reduce the postoperative mortality of heart failure (HF) patients. [Display omitted] Although dielectric elastomer (DE) with substantial actuated strain (AS) has been reported 20 years ago, its scientific understanding remains unclear. The most accepted theory of DE, which is proposed in 2000, holds the view that AS of DE is induced by the Maxwell stress. According to this theory, materials have similar ratios of permittivity and Young's modulus should have similar AS, while the experimental results are on contrary to this theory, and the experimental AS has no relationship with ideal AS. Here, a new dipole-conformation-actuated strain cross-scale model is proposed, which can be generally applied to explain the AS of DE without pre-strain. According to this model, several characteristics of an ideal DE are listed in this work and a new DE based on polyphosphazene (PPZ) is synthesized. The AS of PPZ can reach 84% without any pre-strain. At last, a PPZ-based all soft artificial heart (ASAH) is built, which works in the similar way with natural myocardium, indicating that this material has great application potential and possibility in the construction of an ASAH for heart failure (HF) patients. [ABSTRACT FROM AUTHOR]