1. Ventricular Assist Devices Topics in Bioengineering

2. Increasing use of VADs as bridge to transplantation Klotz et al. (2008) Prog Biophys Mol Biol

3. Overview of VAD types Klotz et al. (2008) Prog Biophys Mol Biol; http://my.clevelandclinic.org/heart/disorders/heartfailure/lvad_devices.aspx http://my.clevelandclinic.org/heart/disorders/heartfailure/lvad_devices.aspx http://texasheart.org/Research/Devices/abiocor.cfm http://medgadget.com/2007/07/pediaflow_ventricular_assist_device.html

5. The HeartMate II VAD Miller et al. (2007) NEJM. Figure 1 Griffith et al. (2001) Ann Thorac Surg. Figure 2

6. Flow visualization around inlet stator and rotor Griffith et al. (2001) Ann Thorac Surg. Figure 3

7. Tethered and untethered configurations Griffith et al. (2001) Ann Thorac Surg. Figures 4 and 5

8. Pressure-flow relationships for HeartMate II Griffith et al. (2001) Ann Thorac Surg. Figure 6

10. Baseline characteristics of the patients (1) Miller et al. (2007) NEJM. Table 1 Normal: 55-70% 2.6-4.2 9-18

11. Baseline characteristics of the patients (2) Miller et al. (2007) NEJM. Table 1 N N N N N H - renal H - liver N H – tissue breakdown, various

12. Baseline characteristics of the patients (3) Miller et al. (2007) NEJM. Table 1 Increase contraction Edema Hypertension Hypertension, HF Arrhythmia Arrhythmia, HF Hypertension Arrhythmia (ventricular) Anticoagulant

13. Blood clotting cascade http://www.biosbcc.net/doohan/sample/htm/Hemostasis.htm

14. NYHA Heart Failure Class http://www.abouthf.org/questions_stages.htm

15. Functional status and quality of life Miller et al. (2007) NEJM. Table 2

16. Functional status and quality of life Miller et al. (2007) NEJM. Table 2 Plot on graph?

17. Outcomes of the patients Miller et al. (2007) NEJM. Table 3

18. Outcomes of the patients Miller et al. (2007) NEJM. Figure 2

19. Adverse events in the study Miller et al. (2007) NEJM. Table 4

20. Adverse events in the study Miller et al. (2007) NEJM. Table 4

21. Testimony from a patient http://www.youtube.com/watch?v=_dj ouz093Us&feature=endscreen

22. Questions for discussion Is it worth the risk? What major issues still need to be addressed? What can BMEs do to improve VAD design? What about for other patient populations (eg, women and children)? Other thoughts, ideas, critiques? http://medgadget.com/2007/07/pediaflow_ven tricular_assist_device.html