An experimental and numerical study of the flow and mass transfer in a model of the wearable artificial kidney dialyzer.

Background: Published studies of the past decades have established that mass transfer across the dialyzer membrane is governed by diffusion, convection and osmosis. While the former is independent of the pressure in the liquids, the latter two are pressure dependent and are enhanced when the pressure difference across the membrane is increased. The goal of the present study is to examine the impact of pulsatile flow on the transport phenomena across the membrane of a high-flux dialyzer in a wearable artificial kidney (WAK) with a novel single small battery-operated pulsatile pump that drives both the blood and dialysate in a counter-phased manner, maximizing the trans-membrane pressure.

A wearable haemodialysis device for patients with end-stage renal failure: a pilot study.

Background: More frequent haemodialysis can improve both survival and quality of life of patients with chronic kidney disease. However, there is little capacity in the UK to allow patients to have more frequent haemodialysis treatments in hospital and satellite haemodialysis units. New means of delivering haemodialysis are therefore required.

A wearable hemofilter for continuous ambulatory ultrafiltration.

Ultrafiltration is effective for treating fluid overload, but there are no suitable machines for ambulatory treatment. This study summarizes the use of a light-weight wearable continuous ambulatory ultrafiltration device consisting of a hollow fiber hemofilter, a battery operated pulsatile pump, and two micropumps to control heparin administration and ultrafiltration. Six volume-overloaded patients underwent ultrafiltration for 6 h with treatment discontinued in one patient due to a clotted catheter.

Role of vortices in growth of microbubbles at mitral mechanical heart valve closure.

This study is aimed at refining our understanding of the role of vortex formation at mitral mechanical heart valve (MHV) closure and its association with the high intensity transient signals (HITS) seen in echocardiographic studies with MHV recipients. Previously reported numerical results described a twofold process leading to formation of gas-filled microbubbles in-vitro: (1) nucleation and (2) growth of micron size bubbles. The growth itself consists of two processes: (a) diffusion and (b) sudden pressure drop due to valve closure.

Optimal vortex formation as an index of cardiac health.

Heart disease remains a leading cause of death worldwide. Previous research has indicated that the dynamics of the cardiac left ventricle (LV) during diastolic filling may play a critical role in dictating overall cardiac health. Hence, numerous studies have aimed to predict and evaluate global cardiac health based on quantitative parameters describing LV function.

Continuous renal replacement therapy for congestive heart failure: the wearable continuous ultrafiltration system.

Ultrafiltration is effective in the treatment of fluid and sodium overload in congestive heart failure. There is no available device to provide this therapy to ambulatory patients. We built and tested in vivo a wearable belt that can provide continuous ultrafiltration, 168 hours a week.

Mitral mechanical heart valves: in vitro studies of their closure, vortex and microbubble formation with possible medical implications.

Objective: The goal of the present work was to create the closest possible in vitro fluid dynamic environment in which prosthetic mitral valves in the patients' hearts function, in order to demonstrate whether microbubbles are generated, and if yes, under what conditions and at which stage of the cardiac cycle. Microbubbles were observed in the blood of patients with mitral mechanical heart valves (MHV) by means of echocardiography. The phenomenon, often referred to as high-intensity transient signals (HITS), appears as bright, intense, high-velocity and persistent echoes detected by Doppler echocardiography at the instant of valve closure.

Detection of calcium deposits on heart valve leaflets by vibro-acoustography: an in vitro study.

The presence of calcium deposits on heart valve leaflets constitutes a clinically significant diagnostic indication. A novel method for imaging and detecting calcium deposits on tissue heart valves is presented. The method, called vibro-acoustography, uses the radiation force of ultrasound to vibrate the tissue at low (kHz) frequency and records the resulting acoustic response to produce images that are related to the hardness of the tissue.

Three-dimensional imaging of fractures in outlet struts of Björk-Shiley convexo-concave heart valves by microcomputed tomography in vitro.

Background And Aims Of The Study: For implanted Björk-Shiley convexo-concave (BSCC) heart valves, structural failure of the valve's U-shaped outlet strut results in embolization of its blood flow-regulating disc (occluder), with consequent patient morbidity and mortality. After a variable and unpredictable number of cardiac cycles, one strut leg may fatigue ('single-leg separation'; SLS); subsequently the other strut leg may also fatigue, resulting in full structural failure ('outlet strut failure'; OSF). Some BSCC valves are believed to be at more risk of SLS and OSF than others.

Vortex shedding as a mechanism for free emboli formation in mechanical heart valves.

The high incidence of thromboembolic complications of mechanical heart valves (MHV) limits their success as permanent implants. The thrombogenicity of all MHV is primarily due to platelet activation by contact with foreign surfaces and by nonphysiological flow patterns. The latter include elevated flow stresses and regions of recirculation of blood that are induced by valve design characteristics.

A physical model describing the mechanism for formation of gas microbubbles in patients with mitral mechanical heart valves.

This study was aimed at developing a physical model, supported by experimental observations, to describe the formation and growth of microbubbles seen in patients with mitral mechanical heart valves (MHV). This phenomenon, often referred to as high intensity transient signals (HITS), appears as bright, intense, high-velocity and persistent echoes detected by Doppler ultrasonography at the instant of closure. The long-term clinical implications of HITS has yet to be determined.

Microbubbles and mitral valve prostheses - transesophageal echocardiographic evaluation.

Objective: To assess whether microbubbles are associated with a specific type of mitral valve prosthesis and to investigate the relationship of microbubbles to ventricular function and mitral regurgitation. One of the types of spontaneous echocardiographic contrast observed in patients with prosthetic heart valves has been described as microbubbles.

Methods: Clinical data and videotapes of patients with a prosthetic mitral valve who had undergone transesophageal echocardiography at the UCLA Medical Center between May 1989 and February 1995 were retrospectively reviewed.