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Biomedical subjects

K S Holmes

Publications and source records attributed to K S Holmes.

13 recordsLinked to original sources
PubMed2001

The HeartSaver left ventricular assist device: an update.

BACKGROUND: Ventricular assist devices have been shown to be effective as bridges to transplantation and recovery for patients with end-stage heart failure. Current technology has been limited because of the need for percutaneous connections with controllers. The HeartSaver ventricular assist device (VAD) (World Heart Corporation, Ottawa, Ontario, Canada) was developed with the intention of having a completely implantable, portable VAD system. The system consists of an electrohydraulic blood pump, internal and external battery power, and a transcutaneous energy transfer and telemetry unit that allows for power transmission through the skin. Control of the device may be achieved locally or remotely through a variety of communication systems. METHODS: The device has been modified with the Series II preclinical version being available for in vitro (mock loop) and in vivo (bovine model) testing. RESULTS: Seventeen Series II devices have been functional on mock loops or other testing trials for an accumulated 900 days of operation. There have been eight acute experiments using a bovine model to test various components as they have become available from manufacturing. Mean pump output was 10.4 +/- 1.1 L/min in full-fill/full-eject mode. Changes in the last 24 months include (1) cannula redesign for better port alignment and integration of tissue valves; (2) battery redesign to convert to new lithium-ion cells; (3) optimized infrared information and electromagnetic inductance energy transmission through various skin thicknesses and pigmentation; and (4) improved reliability of internal and external controller hardware and software. CONCLUSIONS: Modifications have been required to optimize the HeartSaver VAD's performance. The final HeartSaver VAD design will be produced in the near future to allow for formal in vitro and in vivo testing before clinical implantation.

Animals↗
PubMed1999

Progress with the HeartSaver Ventricular Assist Device.

BACKGROUND: Ventricular assist devices (VADs) have been shown to be effective for short- or long-term circulatory support. Devices are either being adapted or newly designed for longer term or permanent support, with the goal to provide patients with improved quality of life. Since 1990, a program has been in place to develop a totally implantable, permanent VAD. METHODS: A multidisciplinary team is developing this VAD with specific goals in mind: (1) that it have an intrathoracic position, (2) that it be a totally implantable device without any percutaneous connections, and (3) that it be possible to communicate with the device from remote locations. These goals would allow for complete patient mobility and flexibility for follow-up. RESULTS: The electrohydraulically actuated VAD combines the blood pump, volume displacement chamber, energy converter, and internal electronic module into a single compact unit. The device called the HeartSaver VAD is powered by a transcutaneous energy transfer system and can be remotely monitored and controlled. Prototypes of different versions of the device have been tested in vitro and in vivo with satisfactory performance. CONCLUSIONS: The prototypes of the HeartSaver VAD have functioned well under test conditions and fulfilled the outlined goals. Further development and testing of the design are being conducted before clinical availability.

Animals↗
PubMed1997

Wireless monitoring and control for implantable rotary blood pumps.

A wireless biotelemetry system for the transfer of digital data through intact skin and tissue has been developed to provide a safe and noninvasive means of communication between implanted medical devices and the outside of the body. The system utilizes 2 miniature infrared transmitter/receiver modules. Data are transmitted through intact skin and subcutaneous tissue on an 890 nm infrared carrier signal. The system has been evaluated in human cadavers and during in vivo implantation of artificial hearts and ventricular assist devices for durations of up to 96 h. Acceptable data transfer (error rate < 10(-5)) through a typical tissue thickness of 5-25 mm has been demonstrated. The ability to monitor and control a device from a remote site using public communication systems such as telephone lines and asynchronous transfer mode (ATM) systems has also been demonstrated. Design optimization is currently ongoing in preparation for clinical utilization with artificial heart systems and other implantable devices (such as rotary blood pumps).

Animals↗
PubMed1996

A remotely controlled and powered artificial heart pump.

An intrathoracic pulsatile artificial heart pump has been developed. Transcutaneous energy transfer and biotelemetry systems provide continuous power and remote monitoring and control, with no percutaneous connections required. The electrohydraulic system can be used either as a ventricular assist device or with modifications as a total artificial heart. The device uses a unidirectional axial flow pump coupled with a pressure activated one-way valve to allow hydraulic fluid to passively return to the volume displacement chamber during diastole. The transcutaneous energy transfer system provides power to the device and recharges the implantable battery pack. A wearable external controller and external battery pack provide the patient enhanced mobility and thus an improved quality of life. The biotelemetry system allows control and monitoring of the device after implantation, as well as an added capability to monitor and control the device remotely over public communication lines. Early prototypes have functioned failure free for up to 3 years in vitro. The device has sustained circulation in vivo for up to 4 days. Design optimization is continuing, and chronic in vivo evaluation is planned.

Animals↗
PubMed1996

Transcutaneous energy transfer with voltage regulation for rotary blood pumps.

Rotary blood pumps often require a constant operating voltage. To meet this requirement and to eliminate the need for percutaneous leads, a voltage-regulated transcutaneous energy transfer (TET) system has been developed. Voltage regulation is achieved by using a transcutaneous infrared feedback control loop operating on a 890 nanometer (nm) wavelength. In vitro testing of the system developed has shown that output voltage can be maintained to within 0.2 V of nominal (14.5 V) for delivered powers up to 50 watts (W) and coil separations of between 3 and 10 mm. Power transfer efficiencies were determined to be from 68% to 72% over the tested range of coil separations and output currents from 1.5 to 3.6 amperes (A). This system has demonstrated acceptable performance in regulating output voltage while transferring power inductively without using percutaneous connections. By integrating this type of TET system with an implanted rotary blood pump, the quality of life for the device recipient could be improved.

Energy Transfer↗
PubMed1993

Transcutaneous energy transfer system performance evaluation.

A transcutaneous energy transfer (TET) system has been developed to power implantable devices such as artificial hearts, defibrillators, and electrical stimulators. Transcutaneous coupling of power to these implanted devices remains a favorable alternative as percutaneous lines are avoided in order to eliminate the potential of infection and allow patient mobility. In vitro, in vivo, ex vivo, and human cadaver studies of the electrohydraulic ventricular assist device TET have demonstrated that power can be transmitted over a range of skin thicknesses of 3-15 mm and can tolerate radial misalignments of up to 20 mm. Sensitivity to coil separation and radial misalignment variations has been addressed by the development of an auto-tuning TET. The system has only a 10% attenuation in secondary coil voltage when metallic objects are in contact with the primary coil. The system has demonstrated a power transfer efficiency of 60-80% for power demands from 5 to 70 W. The TET secondary coil will provide an output voltage of 10-25 V for current demands from 0.5 to 4.0 A. TET chronic studies in porcine models have demonstrated no adverse effect to the tissue when up to 40 W of power can be delivered to an implanted load without the tissue-contacting surface of the coil exceeding 42 degrees C. In conclusion, the TET is a feasible alternative for tether-free power transmission.

Cadaver↗
PubMed1984

Respiratory mutants of Azotobacter vinelandii with elevated levels of cytochrome d.

A method is described for the isolation of respiratory mutants of Azotobacter vinelandii with increased amounts of d-type cytochrome by selecting for the inability to reduce tetrazolium red. Five stable mutants were obtained that had six-fold higher levels of cytochrome d, increased amounts of b-type and lower amounts of o-type and c-type cytochromes than the wild-type strain. Spectral alterations in cytochrome alpha 1 were also observed in the mutants. NADH and succinate oxidase activities of membrane particles were about two fold higher in the mutants compared to the wild-type strain. Ascorbate-N,N,N',N'-tetramethyl-p-phenylene diamine oxidase activity was barely detectable in membrane particles of the mutants. These results are consistent with an increase in the amount of the cytochrome d oxidase branch and a decrease in the amount and activity of the cytochrome o, alpha 1 oxidase branch in the mutants. Growth rates under oxygen-excess conditions and respiratory-linked proton translocation ratios of the mutant and wild-type stains were similar as were the photochemical spectral and kinetic properties of cytochrome d.

Azotobacter↗
PubMed1982

Effect of O2 limitation on growth and respiration of the wild type and an ascorbate-tetramethyl-p-phenylenediamine-oxidase-negative mutant strain of Azotobacter vinelandii.

Azotobacter vinelandii strain AVOP (wild type) and an ascorbate-N,N,N',N'-tetramethylene-p-phenylenediamine oxidase-negative mutant (AV11) were each grown in O2-limited chemostat cultures. The results showed that the mutant strain grew and used O2 less efficiently than the wild-type strain. Respiration rates of membrane particles with NADH or malate as the substrate were similar for each strain. Succinate oxidase activity was about fourfold lower in membrane particles prepared from mutant than from wild-type strain. Cyanide at a concentration that completely inhibited ascorbate-TMPD oxidase activity resulted in a 50% inhibition of NADH oxidase activity in membrane particles of AVOP. These data suggest that the cytochrome o, a1, oxidase branch of the respiratory chain may be important in the physiology of A. vinelandii under O2-limiting growth conditions.

Azotobacter↗
PubMedDate not supplied

A transcutaneous energy and information transfer system for implanted medical devices.

During the last four decades there has been a rapid increase in the development and usage of medical devices. Currently, there are more than 500,000 devices on the market and 25,000 new devices enter the market each year. Many medical devices are now designed to be implantable (pacemakers, defibrillators, circulatory assist devices, artificial hearts, cochlear implants, neuromuscular stimulators, biosensors, etc.). Almost all of the active devices (those that perform work) and many of the passive devices (those that do not perform work) require a source of power. In addition, these devices need to be monitored and controlled, which can be accomplished by utilizing remote communication methods. A transcutaneous energy transfer system combined with a remote communications system has been developed and evaluated in vitro and in vivo (bovine, porcine, and human cadaver experiments). The energy transfer system can deliver up to 60 W with power transfer efficiencies between 60 and 83%. An automatically tuned, resonant frequency tracking method is used to obtain optimum power transfer over a range of operating conditions. The remote communications system can transfer digital data bidirectionally through intact skin at rates up to 9600 baud. The system transmits information by frequency modulating an 890 nm infrared carrier signal. The system has demonstrated satisfactory performance during multicenter evaluation with ventricular assist and total artificial heart devices. Design improvements have been identified, which will be implemented to produce an optimized system for energy transfer to and remote communications with various implantable medical devices.

Animals↗