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Biomedical subjects

W M Phillips

Publications and source records attributed to W M Phillips.

34 records · Page 2Linked to original sources

Total artificial heart implantation in calves with pump on an angled port design.

The APP was employed in our 21st TAH calf and has now been implanted in a total of 11 animals. The APP has a dynamic stroke volume of 105 ml, an ejection fraction of 75%, and a peak flow of 14 L/min. The TAH features 2 APPs which have polysulfone cases and contain smooth, seam-free polyurethane sacs. Concavoconvex Bjork-Shiley valves are used. The pumps are pneumatically driven but may be easily converted to pusher-plate drive. A pneumatic drive console and an automatic control unit complete the system. The automatic control unit permits independent control of the right and left hearts as a function of left atrial and aortic pressure respectively. The average survival of the APP TAH calves has been 65 days. Hematologic study has revealed basically normal results with minimal elevation of serum hemoglobin and lactic acid dehydrogenase (LDH), indicative of a low level of hemolysis. Elelvation of central venous pressure (CVP) and total blood volume continue to be a problem with some TAH calves but not all. The APP has led to a dramatic increase in duration of survival and decrease in thromboembolism.

Animals↗

A two and one half year clinical experience with a mechanical left ventricular assist pump in the treatment of profound postoperative heart failure.

A sac-type paracorporeal left ventricular assist pump was implanted in 9 patients suffering from profound left ventricular failure following open heart surgery. Two patients had good recovery of left ventricular function and were weaned from assist. One survived 14 months postoperatively. Primary causes of death among the remaining patients were (1) primary right ventricular failure, (2) assist pump inlet cannula obstruction and (3) excessive bleeding. The strategies developed or proposed to deal with these problems include, respectively: (1) biventricular assist for patients with concomitant right ventricular failure; (2) cannulation of the left atrium to avoid inlet cannula obstruction by the left ventricular wall and intraventricular septum; (3) more rapid selection of left assist candidates and more rapid implantation techniques to reduce the coagulopathy associated with prolonged cardiopulmonary bypass, and an effective autotransfusion system to augment blood replacement.

Adult↗

Determining arterial pressure, left atrial pressure and cardiac output from the left pneumatic drive line of the total artificial heart.

These data presented here demonstrate how careful analysis of mock loop testing can lead to useful measurements for long-term calf experiments. The accuracy of the data rae primarily dependent upon a valid circulatory system analog and good experimental technique. These methods of determining arterial pressure, left atrial pressure and cardiac output have allowed us to obtain recordds of these important parameters for periods as long as 100 days in calves with total artificial heart implantation. These methods have also enabled us to automatically control the artifical heart under conditions of rest, exercise and pharmacologic treatment with the use of only one external pneumatic drive line pressure transducer.

Animals↗

Similarity between complexity on Role Construct Repertory Technique and articulation on Draw-A-Person test for patients and non-patients.

In an investigation of the underlying unity of the articulation of human figure drawings and personal construct complexity, moderate correlations were found, but in opposite directions, for inpatient and non-patient groups. For inpatients, greater construct complexity was associated with less sophisticated drawings. For non-patients, greater construct complexity was correlated with more sophisticated human figures. Mean and range differences in complexity and articulation scores between the two groups suggested that the higher complexity scores of the patient group indicated a loss of construct coordination, rather than greater articulation and organization of self and interpersonal experience.

Adolescent↗

A pressure-measuring system for long-term in vivo pressure measurements.

A new balloon-tipped catheter has been developed for the purpose of making long-term vivo intravascular pressure measurements. Among its advantages are its ability to electrically isolate the subject from the pressure transducer and be rebalanced and calibrated while in situ. Experimental results in calves indicate that the system provides a very reliable means of calibrating implanted catheter tip pressure transducers in situ and can be used as the primary long-term pressure measuring device when high frequency response is not required.

Animals↗

A comparison of three ventricles used for left ventricular bypass in the calf.

Long-term synchronized left ventricular bypass has been performed in calves using pneumatically powered pumps having a smooth lining fabricated of segmented polyurethane. Three different pump designs have been employed: a) sac pump, b) longitudinal tethered sac pump, and c) transverse tethered sac pump. Sizeable thrombi occurred in the apex of the sac and longitudinal tethered sac pumps. In the transverse tethered sac pumps, a considerably smaller thrombus was seen only at the flexion point on the inlet side of the pump. Thrombi occurred in areas of low flow velocity and were not prevented by anticoagulation or surface coating techniques. This study indicates the importance of ventricle design in the development of thrombus free pumps and suggests modifications to the present pumps to reduce or eliminate thrombus formation.

Animals↗

Complete left ventricular bypass with a paracorporeal pump: design and evaluation.

A multidiscipline group was established at The Pennsylvania State University to design and evaluate mechanical circulatory assist devices and the artificial heart. The group has designed a left ventricular to aortic assist system which consists of a sac-type pump, a synchronization unit, a pneumatic power unit, and appropriate monitoring apparatus. The assist system has been evaluated for long-term circulatory assistance in a series of ten calves. The assist pump was placed in the paracorporeal position. The longest period of continuous pumping was over eight months. The last four calves have had synchronized assist pumping which has permitted prolonged ventricular decompression and assist pump flow rates as high as 10 L/min. Three of these four calves had no evidence of thromboemboli. Additional animal studies will be required before clinical use of such an assist pump system can be safely undertaken.

Animals↗