Showing 3 ideas for tag "circulatory"

Goal 2: Reduce Human Disease

Understanding Right Ventricular Function and Failure

There is a need for understanding of right heart failure (RHF) and its consequences following left ventricular assist device (LVAD) support, as well as to develop devices to optimally support the right ventricle.

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Critical Challenge (CC)

Details on the impact of addressing this CQ or CC

Understanding the pathophysiology and risk factors of right heart failure in the context of LVAD use might lead to preventative and therapeutic options for these patients.

Feasibility and challenges of addressing this CQ or CC

Current resources in terms of a National Registry for VADS (INTERMACS) exists and can be leveraged.
While we have a substantial understanding of the risk factors associated with poor outcomes of patients with heart failure and left ventricular dysfunction, much less is known about the syndrome of heart failure and right ventricular (RV) dysfunction. Right-sided heart failure occurs in approximately 20% of patients receiving LVAD support. Investigation into the pathophysiology of right ventricular failure and its consequences following LVAD support, including identification of risk factors and treatment strategies, remains a high priority according to the Joint NHLBI-American Association for Thoracic Surgery (AATS) Working Group convened in 2011 (http://aats.org/CME/2011-AATS-NHLBI-Symposium.cgi). Development of new devices designed to optimally support the RV are warranted.

Name of idea submitter and other team members who worked on this idea NHLBI Staff

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Goal 2: Reduce Human Disease

Optimal Use of mechanical circulatory support devices to Minimize Pump Thrombosis & AEs

There is a need for the development of a collaborative observational study that leverages off of existing registries, such as INTERMACS and STS, that will follow mechanical circulatory support devices (mechanical circulatory support device) patients prospectively and collect process-of-care data to identify 1) optimal approaches for the management of patients and 2) pumps to minimize the occurrence of adverse hemodynamic... more »

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Critical Challenge (CC)

Details on the impact of addressing this CQ or CC

Completion of the proposed observational study would optimize mechanical circulatory support device/left ventricular assist device use and minimize serious adverse events such as pump thrombosis.

Feasibility and challenges of addressing this CQ or CC

Use of mechanical circulatory support is expanding to less sick populations, so optimal and safe use of these devices is critical.
Mechanical circulatory support devices (mechanical circulatory support device) have become important therapeutic options for patients with advanced heart failure. Considerable efforts are underway to develop newer generations of devices that are smaller, more durable and reliable, with fewer adverse events. However, mechanical circulatory support devices that are currently being used continue to have considerable risks and hemodynamic complications associated with them including bleeding, stroke, and intra-pump thrombus formation. Many factors influence the occurrence of these adverse events in patients receiving mechanical circulatory support devices, including patient selection, patient management such as the anticoagulation regimen used, pump selection, surgical placement and implantation of the pump, and mechanical aspects of the pump including pump speed and pulsatility, among other factors. The existence of multiple factors and complexities influencing and contributing to these adverse event outcomes preclude a standard clinical trial approach.

Name of idea submitter and other team members who worked on this idea NHLBI Staff

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15 up votes
11 down votes
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Goal 2: Reduce Human Disease

How to organize artificial pulsatile propelling of blood maintaining the balanced circulation?

Venous pressure, being very low, distends (deforms) the ventricle - but due to elastic or viscous law of deformation? Elastic deformation depends on stress (pressure) only and the viscous one - on stress and time. When pressures are low you can't get large distention due to stress only (time-independent) unlike the case when you apply low stress and long time interval. If we want to use venous pressure as one of regulators... more »

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Compelling Question (CQ)

Details on the impact of addressing this CQ or CC

The impact (in case of constructive solution of the problem) can be expected as a breakthrough in the field of engineering of extracorporal circulatory devices and artificial heart. More exactly: the impact will concern the dosage of blood while filling of the ventricle - without intrusion into the essential levels of venous pressure (the levels play the role of regulators together with levels of diastolic arterial pressure).

Feasibility and challenges of addressing this CQ or CC

The feasibility of implementation (engineering of a device) of the above idea depends on preliminary supercomputer modeling of blood circulation based on simulation of viscous relaxation of ventricle combined with the controlling of circulation according to the deduced equation (see the reference).

Name of idea submitter and other team members who worked on this idea Kamnev Yuri

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11 down votes
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