文档介绍：该【生物材料人工心脏 】是由【读书之乐】上传分享，文档一共【32】页，该文档可以免费在线阅读，需要了解更多关于【生物材料人工心脏 】的内容，可以使用淘豆网的站内搜索功能，选择自己适合的文档，以下文字是截取该文章内的部分文字，如需要获得完整电子版，请下载此文档到您的设备，方便您编辑和打印。*生物材料人工心脏*,000deathsperyearintheUnitedStatesandcontributestothedeathofanother220,,000newcasesdiagnosedannuallyandthosediagnosedwiththisconditionhaveamortalityrateofabout50%at5years(AmericanHeartAssociation,1999).Forend-eaneffectivetreatmentoverthepast20years,%at3years(anSharing,1999).essofhearttransplantationislimited,however,,000–64,000patientscouldpotentiallybenefitfromhearttransplantationannually(Funk,1991),in2003,,approximately20%ofindividualslistedforhearttransplantationdieannually(anSharing,1999).Toaddresstheneedtosupportthecirculationinpatientswithend--to-cardiactransplantationwillbediscussedinthischapter,aswillcirculatorysupportdevicesthatmayenterthemarketinthenearfuture.*生物材料人工心脏*Thesedevicesdonotreplacethepatient’sheart(aswouldatotalartificialheart),butratherworkasventricularassistdevices(VADs).*生物材料人工心脏*VADshaveprovidedcirculatorysupporttoend-%ofpatientsundergoingVADsupporthavesurviveduntilhearttransplantation(Mehtaetal.,1995).PatientsundergoingVAD“bridging”generallydonotundergofurtherdeteriorationintheirconditionand,anfunctionandanimprovementintheirhealthstatusduetoimprovedperfusion(Frazieretal.,1994).Ironically,essofVADbridginghasbeenimplicatedinintensifyingthedonorshortagebyincludingrecipientswhowouldotherwisehavenotsurviveduntiltransplantation(Massadetal.,1996).,esscanbeachieved,patientsmustbecarefullyscreenedforthisprocedureandthemajorityofVADpatientsareunlikelytomeetselectioncriteria(Loebeetal.,1999).*生物材料人工心脏*AnotherresultoftheincreasinglypositiveexperienceofsupportingpatientsuntiltransplantationwithVADsistheconceptofusingVADsasapermanentsourceofcirculatorysupportorasa“destinationtherapy.”paringVADimplantationwithmedicaltherapyinpatientswhorequire,butareineligibleforhearttransplantation,hasbeeninitiatedintheUnitedStateswithsupportfromtheNationalHeart,Lung,andBloodInstitute(Roseetal.,1999).Anumberoffactorshaveledtotheconsiderationandinvestigationofpermanentsupport:ansupply,asignificantpatientpopulationthatfailstomeetageandmedicaleligibilityrequirementsfortransplantlisting,,patibilityarecentraltotheperceivedlimitsofutilizingVADsasalternativestotransplantinend-stageheartfailurepatients.*生物材料人工心脏*-1980s,thefirstimplantsoftheJarvik-7totalartificialheart(TAH)intendedforpermanentsupport(DeVriesetal.,1984).However,plicationssuchasinfectionandthromboembolism,aswellasmanufacturingconcerns,*生物材料人工心脏*essofimmunosuppressivetherapieswasbeingreported,(CardioWest,Tucson,AZ)andutilizedinthebridgetotransplantrole(Guy,1998).Hearttransplantation*生物材料人工心脏*,researchanddevelopmentofTAHsisongoing;however,,however,thattheTAHisnotcurrentlyusedinthebridge-tocardiac-(Arabiaetal.,1999;Copelandetal.,1997).VADs*生物材料人工心脏*ThoratecTheThoratecVAD(ThoratecLaboratories,Pleasanton,CA)isbaseduponthePierceDonachyVADoriginallydevelopedinthemid-*生物材料人工心脏*,——Thoralon,aproprietarypolyurethaneelastomerblendedwithasurface-——hatfusesdistallywithaDacrongraft,*生物材料人工心脏*