Engineers Try to Redesign Heart Pump

Alison Marsden, Assistant Professor of Medical & Aerospace Engineering at the University of California at San Diego, and colleagues are working on a computer simulation to develop a better designed heart pump, to analyze the flow patterns in the Berlin heart, and to alleviate its risks that can cause blood clots.

Transcript

00:00:01
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>>: WHEN CARLY NUTTLE WAS BORN IN TUSCAN IN 2007, HER HEART WAS BARELY FUNCTIONING. DOCTORS PULLED HER PARENTS ASIDE AND GAVE THEM THE GRIM NEWS.
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>>: THEY SAID HER HEART WAS IN SUCH BAD SHAPE THAT THEY DIDN'T EXPECT HER TO LIVE THROUGH THE NIGHT.
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>>KENNY: SOME HOW CARLY NUTTLE SURVIVED THAT NIGHT AND HUNG ON FOR THE NEXT TWO WEEKS BUT IT WAS TOUCH AND GO, THEN CARLY GOT A BERLIN HEART. IT'S THE ONLY FDA APPROVED CARDIAC PUMP FOR YOUNG CHILDREN. DOCTORS TOLD HER PARENTS WHO WOULD HOPEFULLY KEEP CARLY ALIVE.
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>>: THAT WAS THE PLAN, GET THE BERLIN HEART ON, LET HER GROW, AND GET BIGGER THEN HOPEFULLY A HEART WOULD BECOME AVAILABLE FOR A HEART TRANSPLANT.

00:00:43
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>>KENNY: AFTER FIVE DAYS, DOCTORS DIALED BACK THE DEVICE. THEY WANTED TO SEE HOW CARLY'S OWN HEART WOULD RESPOND.
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>>: AFTER 15 DAYS, THEY WERE ABLE TO DIAL IT ALL THE WAY DOWN TO 0, AND HER HEART WAS DOING THE WORK IT NEEDED TO DO. SO THEY WERE ABLE TO TAKE THE BERLIN HEART OFF, AND NOW SHE STILL HAS HER OWN HEART AND WE ARE JUST VERY GRATEFUL.
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>>KENNY: CARDIAC SURGEON JACK COPELAND HOOKED CARLY UP TO THE DESCRIES DEVICE. SHE WAS THE YOUNGEST CHILD TO GET ONE ONE. A BERLIN HEART IS OFTEN THE ONLY STANDING BETWEEN CHILDREN WITH DAMAGED HEARTS. THE DEVICE CAN CAUSE SEVERE COMPLICATIONS.

00:01:27
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>>: IT CAUSES CLOTS AND THE STROKE RATE WITH THESE KIDS HAS BEEN ANYWHERE FROM 25% UP TO A HUNDRED PERCENT. THAT'S A PRETTY HIGH RATE AND THAT'S UNACCEPTABLE, REALLY, BY ANYBODY'S STANDARDS AND EVERYBODY'S UPSET ABOUT THAT. BUT IT'S I THINKÊ THAT'S WHERE WE ARE RIGHT NOW.
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>>KENNY: ALLISON MARSDEN HOPES TO CHANGE THAT. SHE'S AN ASSISTANT PROFESSOR AT MECHANICAL AND AERO SPACE ENGINEERING. MARSDEN BECAME INTERESTED IN MEDICAL DEVICES DURING HER POST DOCTORAL TRAINING AT STANFORD.
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>>: I THINK THE ISSUES OF HOW BLOOD FLOWÊ THE PATTERN OF BLOOD FLOW IN SURGERIES AND DEVICES ARE REALLY INTERESTING FROM AN ENGINEERING POINT OF VIEW, BUT ALSO I ENJOY WORKING ON

00:02:23 THOSE PROBLEMS BECAUSE THEIR IMMEDIATE APPLICATION TO SORT OF HUMAN PROBLEMS AND PATIENT CARE.
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>>KENNY: THE BERLIN HEART LOOKS LIKE A SIMPLE DEVICE. MARSDEN SAYS WHAT HAPPENS INSIDE OF IT IS COMPLICATED.
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>>: THIS DEVICE IS MADE UP OF TWO CHAMBERS. THERE'S A BLOOD CHAMBER ON THE TOP, AN AIR CHAMBER DOWN HERE, AND A RATHER THIN MEMBRANE THAT DIVIDES THE TWO CHAMBERS. WHEN THE BOTTOM CHAMBER IS PRESSURIZED, THE MEMBRANE GOES UP AND DOWN, BUT ITS MOTION IS NON LINEAR, MEANING THAT IT BUCKLES IN A COMPLEX PATTERN.
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>>KENNY: MARSDEN HOPES SHE CAN EVENTUALLY DISCOVER HOW THE FLOW PATTERNS INSIDE THE BERLIN HEART RELATE TO THE RISK OF BLOOD CLOTS.

00:03:04 THEN SHE MIGHT BE ABLE TO SUGGEST SOME DESIGN CHANGES. SHE'S BEEN TRYING TO DEVELOP A COMPUTER MODEL THE BERLIN HEART. MARSDEN AND GRADUATE STUDENT CHRIS LONG HAVE BEEN WORKING TO SIMULATE THE INTERPLAY BETWEEN BLOOD, AIR, AND THE COMPLEX MEMBRANE MOTION. TALK ABOUT CHALLENGING. AT EACH OF NEARLY TWO MILLION POINTS INSIDE THE DEVICE, THEY HAVE TO CALCULATE THREE COMPONENTS OF VELOCITY AND PRESSURE. THE MATHEMATICAL EQUATIONS TO COME UP WITH THE SIMULATIONS ARE EXTREMELY COMPLEX. AS A MATTER OF FACT, RESEARCHERS HAD TO USE THE POWER OF SOME SUPERCOMPUTERS HERE ON THE UC SAN DIEGO CAMPUS.

00:03:44 STRUCTURAL ENGINEER YURI BAZILEVS IS WORK ON THE HEART SIMULATION. HE SHARES HER FASCINATION WITH FIGURING OUT HOW TO IMPROVE MEDICAL DEVICES. BAZILEVS SAYS YOU CAN'T JUST PULL SOFTWARE OFF THE SHELF TO SIMULATE INTERACTIONS INSIDE THE HEART ON A COMPUTER.
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>>: SUCH PROBLEMS ARE I WOULD SAY NEARLY IMPOSSIBLE OR IMPOSSIBLE TO DO.
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>>KENNY: BAZILEVS HAS HAD TO USES HIS KNOWLEDGE OF COMPLEX MATHEMATICS AND COMPUTER SCIENCE TO COME UP WITH SOME CUSTOM APPLICATIONS.
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>>: I'VE TAKING THE METHOD I'VE DEVELOPED FOR CARDIOVASCULAR BLOOD FLOW AND APPLYING IT TO THIS VERY INTERESTING AND CHALLENGING PROBLEM.
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>>KENNY: AFTER TWO YEARS OF WORKING ON IT SIMULATIONS, HERE'S WHAT BAZILEVS, MARSDEN

00:04:31 AND LONG HAVE COME UP WITH.
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>>: BASICALLY COLORS INDICATE HOW FAST THE FLOW IS MOVING, AND ON THE BAWTD M HERE IS THE AIR CHAMBER, ON THE TOP IS THE BLOOD CHAMBER, AND THIS MOTION THAT YOUR SEEING IS THIS MEMBRANE THAT GOES UP AND DOWN, AND YOU CAN SEE THAT IT HAS A VERY COMPLEX BUCKLING MOTION, WHICH IS SOMETHING THAT WAS QUITE CHALLENGING TO CAPTURE IN THE SIMULATION. AND WHAT WE'RE INTERESTED NOW IS TO ANALYZE THE FLOW FIELD TO REALLY PICK OUT WHAT ARE THE AREAS OF HIGH RISK IN TERM OF BLOOD CLOT FORMATION.
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>>KENNY: COPELAND IS SKEPTICAL ABOUT WHETHER ARTIFICIAL HEART PUMPS CAN BE SUBSTANTIALLY IMPROVED. HE BELIEVES DOCTORS HAVE TO DO A BETTER JOB OF TREATING PEDIATRIC HEART DISEASE.

00:05:18
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>>: OUR JOB IS TO FIGURE OUT THE BIOLOGY OF WHAT'S GOING ON, AND TRY TO TREAT IT WITH THE APPROPRIATE MEDICATIONS SO THAT FURTHER ITERATIONS AND DEVICES ARE WELCOME, WAT IN THE MEAN TIME WE'VE GOT TO SERVE THE POPULATION THAT NEEDS THESE DEVICES BY OPTIMIZING THE WAY WE TREAT THEM TO MINIMIZE THE AMOUNT OF STROKES IT THAT THEY HAVE.