Advances in Cardiovascular Technology

Advances in Cardiovascular Technology

New Devices and Concepts

1st Edition - June 5, 2022

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  • Editors: Jamshid Karimov, Kiyotaka Fukamachi, Marc Gillinov
  • eBook ISBN: 9780128168622
  • Hardcover ISBN: 9780323958783

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Description

Advances in Cardiovascular Technology: New Devices and Concepts is a comprehensive reference for cardiovascular devices of all types. For engineers, this book provides a basic understanding of underlying pathologies and their prevalence/incidence. It also covers what devices are available, how they are clinically used, and their impact on pathophysiology. In addition, the book presents the constraints imposed on device design and manufacture by the environment in which it is used (e.g., exposure to tissues within the body, blood in particular) and the primary requirements for each specific type of device, including its durability and resistance to fatigue. For clinicians, this book contains information on primary engineering challenges, the types of devices available, their advantages and disadvantages, and the (current and emerging) tools and materials available to device designers.

Key Features

  • Covers innovative procedures and devices in cardiovascular technology
  • Gives an overview of the state-of-the-art technology and a view to the future
  • Features contributions from engineers, clinicians and researchers, taking an interdisciplinary view of the field

Readership

Graduate medical and engineering students, medical residents and clinical fellows, early career medical track, senior engineers and clinicians with interest in cardiovascular medicine and new technology development, and device applications in heart and vascular medicine. Medical researchers; Mechanical engineers; Biomedical engineers

Table of Contents

  • Cover image
  • Title page
  • Table of Contents
  • Copyright
  • Dedication
  • List of contributors
  • Foreword
  • A Tribute to Innovations in Cardiovascular Care Pioneered at Cleveland Clinic
  • Preface
  • Part I: Cardiovascular Practice
  • Chapter 1. The History of Cardiac Device Innovation: the Collaborative Triumph of the Kay-Cross Oxygenator
  • Abstract
  • Chapter Outline
  • Introduction
  • Heart-lung machines and the rise of open heart surgery
  • Developing the Kay-Cross Oxygenator
  • Device design, manufacturing, and sales
  • A practical solution
  • Ease of translation from lab to operating room
  • (Relative) Ease of cleaning, assembly, and operation
  • Tech support and tinkering
  • Conclusion
  • References
  • Chapter 2. The Critical Need for Ongoing Innovation in Cardiovascular Medicine
  • Abstract
  • Chapter Outline
  • Conflict of interest
  • References
  • Part II: Cardiovascular Perfusion
  • Chapter 3. Progress in Cardiovascular Perfusion and Technology
  • Abstract
  • Chapter Outline
  • Introduction
  • Pump
  • Circuit
  • Oxygenator
  • Cardioplegia
  • Neurological protection
  • Conclusion
  • Conflicts of interest
  • References
  • Chapter 4. Organ Perfusion and Cardiopulmonary Bypass Techniques
  • Abstract
  • Chapter Outline
  • Adult perfusion circuit
  • Hemodilution reduction
  • Goal directed perfusion
  • Pediatric perfusion circuit and methods
  • Pediatric autotransfusion
  • GEM premier 3500
  • Adult autotransfusion
  • Arterial line filter technology
  • Oxygenators—current state-of-the-art
  • Oxygenators—room for improvement
  • Heat exchangers
  • Heater-coolers—field modifications
  • Heater-coolers—room for improvement
  • Conclusions
  • References
  • Part III: Mechanical Circulatory Support and Organ Replacement
  • Chapter 5. Demand for Mechanical Circulatory Support
  • Abstract
  • Chapter Outline
  • Introduction
  • Temporary MCS
  • Durable MCS
  • MCS for a pediatric population
  • Contraindications
  • Conclusions
  • References
  • Chapter 6. Continuous-Flow Ventricular Assist Devices
  • Abstract
  • Chapter Outline
  • Abbreviations
  • Introduction
  • Axial-flow pump
  • Centrifugal-flow pump
  • Conclusions
  • References
  • Chapter 7. Research and Development for Creating a Universal Ventricular Assist Device
  • Abstract
  • Chapter Outline
  • Background
  • Technology overview
  • Volute housing enhancements
  • Improvements to rotating assembly
  • Engineering and optimization of motor stator
  • Computational fluid dynamics analysis
  • In vivo testing
  • Summary
  • References
  • Chapter 8. Right Ventricular Assist Device
  • Abstract
  • Chapter Outline
  • Background
  • Right heart failure severity grades
  • Results
  • Discussion
  • Conclusion
  • References
  • Chapter 9. Advanced Approaches for Total Artificial Heart Development
  • Abstract
  • Chapter Outline
  • Introduction
  • Cleveland Clinic total artificial heart design
  • Computational fluid dynamics for biocompatibility analysis
  • Right impeller design changes
  • Total artificial heart for pediatric use
  • Total artificial heart for very small patients
  • Biventricular heart failure support using a dual centrifugal pump
  • Summary
  • References
  • Chapter 10. Cardiac Transplantation and Organ Preservation
  • Abstract
  • Chapter Outline
  • Introduction
  • Which solution to preserve the heart?
  • Warm or cold?
  • Blood or crystalloid? Which carrier for oxygen?
  • Ischemic or nonischemic?
  • How to assess organ preservation?
  • Hurdles and challenges of prolonged cardiac perfusion
  • From cardiac preservation to organ banks
  • Conclusions
  • References
  • Chapter 11. Extracorporeal Membrane Oxygenation in Adults
  • Abstract
  • Chapter Outline
  • Introduction
  • Venovenous extracorporeal membrane oxygenation for respiratory failure
  • Venoarterial extracorporeal membrane oxygenation for cardiac failure
  • Extracorporeal cardiopulmonary resuscitation
  • ECMO anticoagulation
  • Equipment
  • Monitoring
  • Conclusion
  • References
  • Chapter 12. Device-Based Circulatory Support Therapy for Heart Failure with Preserved Ejection Fraction
  • Abstract
  • Chapter Outline
  • Introduction
  • Interatrial shunt device
  • LV expander
  • Electrical therapy for HFpEF
  • Left ventricular assist devices for diastolic dysfunction
  • Devices in development (preclinical)
  • Summary
  • References
  • Part IV: Innovative Surgical Approaches and Interventional Techniques
  • Chapter 13. Cardiac Implantable Devices in Heart Failure: Role of Imaging
  • Abstract
  • Chapter Outline
  • Introduction
  • Types of devices
  • LV remodeling devices
  • Cardiac resynchronization therapy
  • Mechanical circulatory support devices
  • Short-term assist devices
  • IABP devices
  • ECMO devices
  • Impella devices
  • Long-term circulatory support devices
  • Imaging in patients with VAD
  • Total artificial heart
  • Conclusions
  • References
  • Chapter 14. Imaging Technologies and Virtual Planning for Congenital Heart Repairs
  • Abstract
  • Chapter Outline
  • Introduction
  • Cross-sectional imaging overview
  • Role of cardiac computed tomography
  • Role of cardiac magnetic resonance
  • Imaging segmentation
  • CCT versus CMR for segmentation
  • Image rendering: surface versus volume
  • 3D printing
  • Augmented reality and mixed reality
  • Hemodynamic simulation
  • Addressing limitations of advanced 3D imaging and surgical simulation
  • Conclusion
  • References
  • Chapter 15. Evolution of Device Therapies for Cardiovascular Surgical Care in Children
  • Abstract
  • Chapter Outline
  • History of device therapies in children for cardiovascular surgery
  • Mechanical circulatory support
  • Material science and novel devices
  • Conclusion
  • References
  • Chapter 16. Robotic Mitral Valve Surgery: New Techniques and Solutions
  • Abstract
  • Chapter Outline
  • Introduction
  • History of robotics in cardiac surgery
  • Clinical presentation
  • Preoperative testing
  • Surgical technique
  • Tips and pitfalls
  • References
  • Chapter 17. Transcatheter Aortic Valve Procedures: Technology Update
  • Abstract
  • Chapter Outline
  • Introduction
  • Anatomical and clinical requirements for TAVI
  • Technological foundations of contemporary TAVI practice: valve devices
  • Technological development pathways for clinical outcome improvement
  • Other technology pathways
  • Conclusions
  • References
  • Chapter 18. Technology Advancement for Percutaneous Interventions for Mitral Regurgitation
  • Abstract
  • Chapter Outline
  • Introduction
  • Anatomy and pathophysiology
  • Classification of mitral regurgitation
  • Acute mitral regurgitation
  • Chronic primary/organic mitral regurgitation
  • Chronic secondary/functional mitral regurgitation
  • Diagnosis
  • Current treatment options for MR
  • Percutaneous interventions
  • Transcatheter mitral valve repair
  • Conclusion
  • References
  • Chapter 19. Transcatheter Mitral Valve Replacement: Technology Update
  • Abstract
  • Chapter Outline
  • Introduction
  • The challenges inherent to TMVR
  • Devices and technologies
  • Conclusions
  • References
  • Chapter 20. Novel Developments in Tricuspid Valve Assessment and Treatments
  • Abstract
  • Chapter Outline
  • Background
  • Tricuspid stenosis
  • Tricuspid regurgitation
  • Surgical techniques
  • Tricuspid replacement
  • Transcatheter technologies
  • Noninterventional therapies
  • Conclusion
  • References
  • Chapter 21. Innovative Surgical Techniques for Complex Aortic Repair
  • Abstract
  • Chapter Outline
  • Introduction
  • Conclusion
  • References
  • Chapter 22. Innovative Technologies for Hybrid Cardiovascular Repair
  • Abstract
  • Chapter Outline
  • Introduction
  • Coronary revascularization
  • Structural heart disease
  • Aortic disease
  • Miscellaneous
  • Conclusion
  • References
  • Chapter 23. Intraoperative Cardiac Deairing: New Concept and Technology
  • Abstract
  • Chapter Outline
  • Background
  • Cardiac deairing system
  • Design and development
  • Discussion
  • Summary
  • References
  • Part V: Treatment of Cardiac Rhythm Disturbances
  • Chapter 24. Cutting-Edge Technologies for Cardiac Rhythm Treatment: Recent Progress of Catheter Ablation Using Radiofrequency Current and Pulsed Electric Field
  • Abstract
  • Chapter Outline
  • Introduction
  • Recent progress of radiofrequency ablation systems
  • Pulsed electric field ablation
  • Conclusion
  • References
  • Chapter 25. Modern Technologies for Cardiac Resynchronization Therapy
  • Abstract
  • Chapter Outline
  • Abbreviations
  • Introduction
  • Cardiac resynchronization therapy
  • Device-based algorithms
  • SyncAV
  • Clinical outcome
  • Future
  • Summary
  • References
  • Chapter 26. Innovative Approaches and Technology Platforms for Pacemaker Lead Extraction
  • Abstract
  • Chapter Outline
  • Introduction
  • Preoperative phase
  • Preoperative evaluation and planning
  • Operative phase
  • Managing complications
  • Summary
  • References
  • Chapter 27. Surgical Devices for Cardiac Radio-frequency Ablation
  • Abstract
  • Chapter Outline
  • Introduction
  • Transfer from clinical need to technology—problem definition
  • RF ablation principles
  • Design solutions
  • Future advancements in cardiac ablation
  • References
  • Chapter 28. Novel Devices for Epicardial Left Atrial Appendage Management
  • Abstract
  • Chapter Outline
  • Introduction
  • Transfer from clinical need to technology
  • Development path to state of art technologies
  • State of the art
  • Future directions
  • References
  • Chapter 29. Technology for Surgical Cardiac Cryoablation Procedures
  • Abstract
  • Chapter Outline
  • Introduction
  • Translating clinical drivers to technology needs
  • Development path to state-of-the-art technologies
  • State-of-the-art technologies
  • Future directions
  • References
  • Part VI: Hemodynamic Patient Monitoring
  • Chapter 30. Basic Hemodynamic Parameters
  • Abstract
  • Chapter Outline
  • Introduction to the cardiovascular system
  • Left heart and systemic circulation
  • Right heart and pulmonary circulation
  • Hemodynamic parameters of the systemic circulation
  • Hemodynamic parameters of the pulmonary circulation
  • Cardiac output
  • Secondary parameters: vascular compliance, elastance, resistance
  • Oxygen saturation
  • References
  • Chapter 31. Wearable Technologies for Cardiac Monitoring
  • Abstract
  • Chapter Outline
  • Introduction
  • Historical innovations for noninvasive measurement devices
  • Contemporary applications
  • Development challenges
  • Summary
  • References
  • Chapter 32. Intelligent Systems and Smart Devices for the Continuous Monitoring of Cardiac Hemodynamics
  • Abstract
  • Chapter Outline
  • Abbreviations
  • Introduction
  • Pressure sensors
  • Volume sensors
  • Flow sensors
  • Outlook
  • References
  • Chapter 33. Microcirculation and Tissue Perfusion Assessments for Complex Cardiovascular Disease Care
  • Abstract
  • Chapter Outline
  • Abbreviations
  • Introduction
  • Microcirculation—the business side of circulation
  • Circulatory failure and oxygen delivery
  • Tissues for noninvasive microvascular examinations
  • The oxygen delivery index concept
  • Oxygen delivery index proof of concept studies
  • Examples of microvascular parameters in health and disease
  • Summary
  • References
  • Chapter 34. Technologies for Hemodynamic Measurements: Past, Present and Future
  • Abstract
  • Chapter Outline
  • Introduction
  • Arterial pressure
  • Venous pressure
  • Flow measurements
  • Additional parameters correlated to hemodynamic monitoring
  • Appendix: Pressure transducers
  • References
  • Part VII: Future Directions of Cardiovascular Technology
  • Chapter 35. Cardiovascular Device Markets: Where Do We Go Now?
  • Abstract
  • Chapter Outline
  • Background
  • Trends in aortic valve replacement
  • Lather, rinse, and repeat?
  • Opportunities in cardiovascular device markets
  • Contribution of cardiovascular technologies to global medical devices and diagnostics market
  • Underserved cardiovascular diseases drive growth opportunities
  • Ingredients for success
  • Industry trends: dollars and deals
  • Conclusions
  • References
  • Chapter 36. Innovation in Cardiovascular Bioelectronics
  • Abstract
  • Chapter Outline
  • Introduction
  • Device features
  • Disease applications
  • Bioelectronics-enabled medical internet-of-things
  • References
  • Chapter 37. Diagnostics and Prevention: Landscape for Technology Innovation in Precision Cardiovascular Medicine
  • Abstract
  • Chapter Outline
  • Introduction
  • Genomic medicine in cardiovascular care
  • Stem cell and tissue engineering in cardiovascular medicine
  • Artificial intelligence in cardiovascular imaging
  • Digital health advances in individualized cardiovascular care
  • Summary
  • Funding support
  • Disclosure
  • References
  • Chapter 38. Devices that Enhance the Biomechanics of the Failing Heart
  • Abstract
  • Chapter Outline
  • Devices for heart failure with reduced ejection fraction
  • Devices for heart failure with preserved ejection fraction
  • Augmentation of atrioventricular valvular biomechanics
  • Conclusion
  • References
  • Chapter 39. Advancement of Technology and Innovation for Future Cardiovascular Care
  • Abstract
  • Chapter Outline
  • Setting the stage
  • Why we need to push for paradigm shifts
  • CVD paradigm shifts: successful innovation and progress
  • Necessary elements for healthcare innovation and progress
  • Emerging and future innovations
  • Threats to innovation and progress
  • One institution’s approach to data stewardship in the age of healthcare innovation and progress
  • Summary and conclusions
  • References
  • Index

Product details

  • No. of pages: 698
  • Language: English
  • Copyright: © Academic Press 2022
  • Published: June 5, 2022
  • Imprint: Academic Press
  • eBook ISBN: 9780128168622
  • Hardcover ISBN: 9780323958783

About the Editors

Jamshid Karimov

Jamshid H. Karimov, MD, PhD, FAHA, FACC is a cardiac surgeon, researcher, inventor and author with extensive experience in device therapies for heart failure, mechanical circulatory support, total artificial hearts, cardiac replacement, and minimally invasive cardiac surgical techniques. He is currently affiliated with the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, and the Department of Biomedical Engineering, Molecular Medicine, Cleveland Clinic Lerner Research Institute. Dr. Karimov’s research interests and innovative work focus on development of simple surgical devices, new methodologies, advanced cardiac therapies, and platform technologies for cardiovascular applications. As an inventor and Principal Investigator, Dr. Karimov conducted first-in-man efforts at Cleveland Clinic. He has achieved the longest in vivo duration for continuous flow total artificial heart implantation. He has also introduced innovative methods for intraoperative cardiac device management and designed new cardiovascular devices.

Affiliations and Expertise

Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Department of Biomedical Engineering, Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, USA

Kiyotaka Fukamachi

Kiyotaka Fukamachi, MD, PhD, is a cardiovascular surgeon by training and has been working full-time in research since joining Cleveland Clinic in 1990. He is Director of the Cardiovascular Dynamics Lab and Section Head of Biomechanical Devices in the Cleveland Clinic Department of Biomedical Engineering. He is also a Professor in the Department of Biomedical Engineering and Department of Molecular Medicine at Cleveland Clinic Lerner College of Medicine of Case Western Reserve University. Dr. Fukamachi has extensive experience in the development and evaluation of mechanical circulatory support devices such as the Cleveland Clinic-Nimbus total artificial heart (TAH), CorAide™ left ventricular assist device (LVAD), MagScrew TAH and LVAD, PediPump™ pediatric circulatory assist device, DexAide right ventricular assist device (RVAD), continuous-flow TAH (CFTAH), and the pediatric version of the CFTAH (P-CFTAH). He has also been involved in simple cardiac devices such as the Coapsys® and the Gillinov/Cosgrove AtriCure AtriClip. Over the course of his career, he has accumulated nearly 300 scientific publications, 254 abstracts, and 330 presentations.

Affiliations and Expertise

Director, Cardiovascular Dynamics Lab and Section Head, Biomechanical Devices, Department of Biomedical Engineering, Cleveland Clinic; Professor, Department of Biomedical Engineering and Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, USA

Marc Gillinov

Marc Gillinov, MD, is Chair of the Cleveland Clinic Department of Thoracic and Cardiovascular Surgery. Since joining Cleveland Clinic in 1997, Dr. Gillinov has become one of the nation’s busiest heart surgeons. He specializes in robotic and minimally-invasive heart valve repair and replacement. His patients range from Academy Award winner Robin Williams to his long-time barber, Vince. A prolific researcher, Dr. Gillinov has more than 450 scientific publications to his credit and has been instrumental in the development of medical devices and treatments that enhance the care of cardiac patients. Spurred by patients’ questions, Dr. Gillinov extended his efforts to help people achieve heart health by teaming with Cleveland Clinic cardiologist Dr. Steven Nissen to write the myth-busting book, “Heart 411: The Only Heart Guide You Will Ever Need.” He also appears on WJW-TV, Fox 8 Cleveland, as “Dr. Marc.” Dr. Gillinov is thrilled and honored to work with the nation’s number one heart team (27 years in a row!) to improve the heart health of people from around the country and around the world.

Affiliations and Expertise

Chair, Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, USA

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