‫‪312.

‬‬ ‫رقم الجلوس‬
‫االولى‬ ‫الفرقة الدراسية‬
‫الثاني للعام الجامعي ‪2020 – 2019‬‬ ‫الفصل الدراسي‬
‫مستجد‬ ‫حالة الطالب‬
‫‪30105101402879‬‬ ‫الرقم القومي‬
‫‪Emadsamir331@gmail.com‬‬ ‫الميل الجامعي‬
‫‪English languages‬‬ ‫اسم المقرر الدراسي‬
‫‪ENG 312‬‬ ‫كود المقرر‬
‫‪The use of mechanical pump‬‬ ‫موضوع البحث‬
‫‪as a solution to heart failure.‬‬
‫‪The use of mechanical pump‬‬ ‫عنوان البحث‬
‫‪as a solution to heart failure.‬‬
 solution to heart failure.

Objectives
1- History
2-

Introduction
Heart failure (HF) is one of the main causes of death in Western Countries.
Its prevalence (1-2 % in the general population) increases exponentially with
age. Over subsequent 3 decades, the population of people aged ≥65 years
with HF is predicted to be quite double, so we will assume that the amount of
individuals in danger of HF will increase dramatically within the near future.
Because of the impossibility of completing a standard surgery in refractory
HF, the sole therapeutical solution during this case is that of a cardiac
transplantation or, if the patient is hemodynamically unstable, the
implantation of a ventricular assist device (VAD) as a bridge to transplant
support. This term includes the biventricular assist devices (which actually
replace the patient's heart) and people assist devices projected to support the
pump function of 1 (RVAD, LVAD) or both ventricles . The development of
VAD led to the belief of several models which differ not just for the type of
technologies used and therefore the implant position but also for the kind of
flow they generate (pulsatile or continuous). Initially conceived as a “bridge
to transplantation” support, only later has the use of VAD been extended to
patients who are not candidates for heart transplant (“destination therapy”).
Nowadays, the most objectives of a mechanical circulatory support program
is to hemodynamically stabilize patients with acute or chronic HF and to
preserve the organ function so as not to preclude subsequent therapeutical
options. Patients with end stage HF usually have symptoms at rest and a
significant impairment of quality of life and are encumbered by a 1-year
mortality of approximately 50%.

1- History
In 1963, DeBakey implanted the primary ventricular assist tool in a affected
person suffering a cardiac arrest following aortic valve alternative. The
affected person eventually died on submit-op day four. In 1966, DeBakey
and Liotta implanted the para corporeal Liotta-De Bakey LVAD in a patient
affected by postcardiotomy shock. The affected person changed into
supported for 10 days and ultimately survived to discharge. soon thereafter,
Cooley mentioned the primary a hit bridge to transplantation the usage of a
pneumatically driven, implantable synthetic coronary heart. despite the fact
that total artificial heart (TAH) research predates VAD studies, the latter
advanced and superior greater quickly. Clinically, the VAD turned into first
intended to carry out briefly till either the heart function recovered or a donor
coronary heart became available for transplantation. intensive studies led to
the first clinically usable structures inside the overdue 1980s and culminated
in FDA approval of a left ventricular help tool (LVAD) as a bridge to
transplantation in 1994, with extra devices receiving approval in 1998. The
operative risk of device implantation need to be weighed against the
potential life-style and survival gain of mechanical aid. The revised
Columbia screening scale posted in 2003 offers a method of stratifying the
threat for LVAD therapy primarily based on numerous clinical elements:
mechanical ventilation, post-cardiotomy, prior LVAD insertion, CVp >16
mmHg and prothrombin time >sixteen seconds. each thing is given a weight
with a cumulative rating of >five, predicting an operative mortality of 46%,
versus a mortality price of 12%, for a rating <5. The timing of intervention is
likewise an critical determinant of scientific consequences. Optimization of
the patient's medical popularity is important however must no longer delay
institution of support in critically ill sufferers with extreme ventricular
failure and ongoing cease-organ malperfusion. VAD implantation is
contraindicated in patients with irreversible quit-organ harm, in particular
renal, hepatic or respiration failure, as those patients have constantly proven
terrible scientific results. intense and unrecoverable neurologic injury also
represents a contraindication to tool implantation. (1,2)
References
1- DeBakey ME. Development of mechanical heart devices. Ann Thorac
Surg. 2005;79:2228–2231.
2- Rao V, Oz MC, Flannery MA, Catanese KA, Argenziano M, Naka Y.
Revised screening scale to predict survival after insertion of a left
ventricular assist device. J Thorac Cardiovasc Surg. 2003;125:855–862.