ABSTRACT

Human body is the most complex machine. It contains many parts which are complex in nature.
When these parts are no longer able to function properly due to physical ailments or disability or
sudden failure, immediate medical attention is necessary.
Since, human life is precious and needs to be saved at any cost, it gets difficult when whole
organ sometimes becomes useless. In such cases organ transplantation needs to be done, which has
rejection problems. Technology
CONTENTS PAGE NO.

ABSTRACT. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0
LIST OF FIGURES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
CHAPTER 1 : ARTIFICIAL HEART . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
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CHAPTER 2 : ARTIFICIAL KIDNEYS. . . . . . . . . . . . . . . . . . . . . . . . . . . 6
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CONCLUSION AND FUTURE WORK. . . . . . . . . . . . . . . . . . . . . . . . . 14
REFERENCES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15

CHAPTER 1:
ARTIFICIAL HEART

Given the arduous physical demands placed on the human heart, it should come as no surprise that
heart disease represents one of society's gravest health risks. Essentially, heart disease is present
when the pumping and circulatory functions congenital and congestive forms of heart disease take an
enormous toll on society. As noted previously, the heart's pumping action supplies the body with the
oxygen and nutrient-rich blood it needs in order to function properly.Persons plagued by early and
middle stage heart disease suffer from a shortage of these life-sustaining elements. Thus, such
persons often tend to feel weak, fatigued, and short of breath.

Artificial heart technology represents society's most promising attempt at filling the above void.
This technology has two main branches. Partial devices supplement patients' natural heart function,
assisting those patients whose organs, while somewhat viable, are incapable of functioning
adequately on their own.

Total artificial hearts (TAH), on the other hand, are devices that actually replace patients'
natural hearts. Such devices are designed for situations in which natural organs are so damaged that
even supplementation via a partial device isn't enough to produce sufficient circulatory function.
Collectively, partial and total artificial heart devices are classified as mechanical circulatory support
systems (MCSS). Surgeons employing these devices face the unenviable challenge of outwitting the
human body. Although it is relatively easy to slip pumps inside the body, it is difficult to do so in a
manner that prevents the body from discovering this intrusion and ultimately rejecting the devices

Ventricular assist device
A ventricular assist device (VAD) is a mechanical circulatory device that is used to partially or
completely replace the function of a failing heart. VADs are designed to assist either the right
(RVAD) or left (LVAD) ventricle, or both at once (BiVAD). The type that is used depends primarily on
the underlying heart disease and the pulmonary arterial resistance that determines the load on the
right ventricle.
The pumps used in VADs can be divided into two main categories a) pulsatile pumps, that mimic the
natural pulsing action of the heart, and b) continuous flow pumps.
a) Pulsatile VADs use positive displacement pumps. In some of these pumps, the volume
occupied by blood varies during the pumping cycle, and if the pump is contained inside the
body then a vent tube to the outside air is required.

b) Continuous flow VADs are smaller and have proven to be more durable than pulsatile VADs.
They normally use either a centrifugal pump or an axial flow pump. Both types have a
central rotor containing permanent magnets. Controlled electric currents running through
coils contained in the pump housing apply forces to the magnets, which in turn cause the
rotors to spin. In the centrifugal pumps, the rotors are shaped to accelerate the blood
circumferentially and thereby cause it to move toward the outer rim of the pump, whereas
in the axial flow pumps the rotors are more or less cylindrical with blades that are helical,
causing the blood to be accelerated in the direction of the rotor's axis. An important issue
with continuous flow pumps is the method used to suspend the rotor. Early versions used
solid bearings; however, newer pumps, some of which are approved for use in the EU, use
either electromagnetic suspension ("maglev") or hydrodynamic suspension. These pumps
contain only one moving part.


Fig. : 1.1 VAD concept of heart Fig. : 1.2 VAD sectional view


Fig.1.3 : Surgical installation of a VAD

Pressure-Volume Relationship

This relationship was first described in Figure . End-systolic volume for a given cardiac cycle
is estimated by one of the imaging techniques,while end-systolic pressure for that cardiac
cycle is obtained from the arterial pressure record at the point of the closure of the aortic
valve (the incisura). Values for several different cardiac cycles are obtained during infusion
of a vasoconstrictor (which increases after load), and the data are plotted. As shown in Figure
1.4, increases in myocardial contractility are associated with a leftward shift in this
relationship. Decreases in contractility (as may be caused by heart disease) are associated
with a downward shift of the line. This method of assessing cardiac function is particularly
important because it provides an estimate of contractility that is independent of the end-
diastolic volume (preload from the pressure-volume loop described by the dotted line in
Figure 1.4 that increases in preload cause increases in stroke volume without changing the
end-systolic volume. Thus only alterations in contractility will cause shifts in the end-systolic
pressure-volume relationship..



Fig. 1.4 : P-V diagram for

Total Artificial Heart
Artificial hearts can now completely, if temporarily, replace the ventricles and valves with a device
made of plastic or other man-made materials, which does the job of pumping blood around.

The type of artificial heart that was given to Green, made by Syncardia Systems, works by using a
pump carried externally in a backpack previously, patients would have to be connected to a large,
immobile pump and would not have the freedom to move around.
Energy transmission
In the artificial hearts produced by AbioMed, an electronics package is implanted in the
abdomen of the recipient of the transplant to monitor and control the pumping of the heart.
Power is supplied from an external source to components under the skin, without penetrating
it, using inductive electromagnetic coupling the same principle as used by transformers to
transfer electricity between different circuits, as in the national grid.
At their simplest, systems of transcutaneous energy transmission will use an external power
supply connected to an external coil of wire, generating a magnetic field in it. This, in turn,
produces an induced voltage in a second coil implanted under the skin, and a rectifier is used
to change this alternating current into direct current that can be used to power the electronics
of the heart and its controller.
Though simple in theory, in practice there are complications that arise from the need to keep
the two coils aligned correctly as the patient moves, in delivering the correct level of power
so that there is no excess dissipated as heat to potentially damage surrounding tissue in the
patients body, and in making the components small enough to be carried around without too
much discomfort.

Fig. 1.5 :Centrifugal blood pump Fig. 1.6 : Exploded view of pump

Monitoring blood flow
A replacement heart needs to be able to monitor the flow of blood to regulate its pumping
and ensure that the correct amount of blood is delivered around the body.
Quicker pumping is required when the transplant recipient is more active, whereas the
opposite is true while he or she is resting.
Blood-flow monitors make use of ultrasound they bounce high-frequency sound waves off
blood cells coming out of the heart, the volume and speed can be measured using similar
basic principles to those behind radar.
Ultrasound is used because it can monitor the flow of blood without having to be in contact
with it.



Appropriate materials
Artificial hearts need to be made of light but durable materials the Syncardia version is
plastic whereas that made by AbioMed is a combination of titanium and a specially
developed polyurethane, called Angioflex.
Although the Abiomed heart is designed to have as few moving parts as possible, those that it
does have are made from Angioflex and are tested to ensure that they are safe for contact
with blood and capable of withstanding beating 100 000 times a day for years on end.
Materials scientists can develop substances with specific properties by manipulating the
constituent elements and the way in which they are processed. Materials are characterised
using various techniques from condensed-matter physics including electron microscopy, x-
ray diffraction and neutron diffraction.
Because they were still quite large, the first devices produced were limited to around half the
male population those with the largest chest cavities. A newer, smaller, model is intended
to extend their availability to smaller people.
An artificial heart being produced by the French medical company Carmat and expected to
be available by 2013 will use chemically treated animal tissue to help avoid rejection by the
hosts immune system. Aerospace engineers from Airbus were also involved in its
development.

Artificial hearts combine, and improve upon, many existing physics ideas to produce a piece
of technology that saves lives although they are currently only approved as a stopgap until
a donor heart can be found.

Fig. 1.5 : Total artificial heart blood flow and installation




Advantages
1. Artificial ventricles are safe and effective methods for the treatment of end stage heart
failure.

2. An artificial heart as a bridge to transplantation gives patients the opportunity to wait for
an acceptable donor at home and allows nearly unlimited mobility.

3. Ventricular assist device as a bridge to myocardial recovery for patients with acute
myocarditis or postoperative heart failure still have limited success.

4. The absence of mechanical failures of the pumping
mechanism is very encouraging in the prospect of long-term
therapy for patients with advanced heart failure.

Disadvantages

1. Continuous-flow rotary pumps significantly reduce but do not eliminate the normal pressure amplitude
associated with the native circulation that may influence long-term organ function.

2. Although the risk of pump thrombosis and thromboembolism (particularly stroke) is low, it has not been
eliminated with the new pump design.

CHAPTER 2

ARTIFICIAL KIDNEYS

Treatment with an artificial kidney is the most widely applied therapy for kidney failure. Substantial
improvements have been made in artificial kidney technology during the past decades, such as with regard to
membrane technology, dialysate composition, and medicate onto address side effects. Despite these
improvements, the high rates of mortality of critically ill patients with acute renal failure (ARF), ranging
between 50% and 70%, did not change for several decades . Also, the rates of morbidity and mortality of
patients with end-stage renal disease (ESRD) receiving treatment with an artificial kidney remain high and the
survival advantage associated with renal transplantation is evident. The problems associated with ESRD are
increasing as the number of patients increases in industrialized countries, whereas the number of kidneys
available for transplantation remains relatively low