Our intraaortic cardiac assistance system for patients in cardiogenic shock following myocardial infarction consists of a catheter and balloon inserted through a femoral arteriotomy into the thoracic aorta. The pumping chamber, activated by helium, is synchronized with the heart by signals from the electrocardiogram or the central aortic pressure transducer. Pumping improved two patients' circulatory status; one survived. Two patients died before pumping could begin; in another, an abdominal aortic aneurysm prevented insertion of the pump. Thrombosis did not occur during pumping; hemolysis appeared minimal. Although final evaluation must await more data, balloon pumping appears to be effective in cardiogenic shock. Further study may establish a place for the procedure in myocardial infarction without cardiogenic shock and in low cardiac output syndromes associated with open-heart surgery.

https://jamanetwork.com/journals/jama/articlepdf/337298/jama_203_2_011.pdf

Initial Clinical Experience With Intraaortic Balloon Pumping in Cardiogenic Shock

In the broadest sense, current hospital therapy of acute myocardial infarction attempts to prevent, or promptly and effectively treat, the electrical and mechanical consequences of regional myocardial ischemia or infarction, while preserving jeopardized ischemic myocardium. Prevention and effective therapy of arrhythmias have largely been realized through the development of coronary-care units. The goals of prompt and effective therapy of disordered cardiac function and preservation of ischemic muscle, although far from achieved, have been greatly advanced in the past several years by the widespread use of hemodynamic monitoring. As a result, new concepts concerning the disease itself and new therapies have . . .

Medical Therapy of Acute Myocardial Infarction by Application of Hemodynamic Subsets

Porcine intestinal mucosal heparin induced aggregation of platelets in citrated platelet-rich plasma and enhanced platelet aggregation and serotonin secretion induced by other agents. This action of heparin was blocked by substances that elevate platelet cyclic AMP and by EDTA but not by inhibitors of platelet cyclooxygenase. The effect was not inhibited by apyrase or by N-amylthio-5'-AMP and therefore did not require the action of ADP, nor was there activation of platelet phospholipase. Platelet aggregation by heparin required a plasma cofactor different from the cofactor required for ristocetin. Fractionation of heparin yielded preparations that varied in molecular weight and, within a given molecular weight fraction, in affinity for antithrombin III. Fractions of high molecular weight (average 20,000) were more reactive with platelets than were fractions of low molecular weight (7,000). Anticoagulant activity did not parallel the platelet reactivity of heparin fractions. Among high molecular weight fractions, preparations of high or low antithrombin affinity were equally active in induction of platelet aggregation. In low molecular weight fractions, there was an inverse relationship between platelet reactivity and anticoagulant activity in normal platelet-rich plasma, but, in platelet-rich plasma depleted of antithrombin, low molecular weight fractions of high and low antithrombin affinity reacted equally with platelets. These results suggest that formation of an antithrombin-heparin complex protected platelets from aggregation by heparin. Selection of heparin fractions of low molecular weight and high antithrombin affinity may improve anticoagulant therapy and development of thromboresistant heparin-coated artificial materials.

/pdf/effect-of-heparin-and-heparin-fractions-on-platelet-2mi6sqymkj.pdf

Effect of Heparin and Heparin Fractions on Platelet Aggregation

Starting from the basic principles of Tesla's wireless power transfer experiment in the 1890s, this review article addresses the key historical developments of wireless power and its modern applications up to formation of the world's first international wireless power standard “Qi” launched in 2010 for portable electronics. The scientific principles laid down by Nicolas Tesla for wireless power transfer, which still remain valid today, are first explained. Then, modern wireless power applications based on nonradiative (near-field) magnetic coupling for short-range applications are described. Some industrial application examples emerging since the 1960s are highlighted. The article then focuses on the comparison of the horizontal and vertical magnetic flux approaches developed in the early 1990s for low-power planar wireless charging pads. Several critical features such as localized charging, load identification, and freedom of positioning that are essential to wireless charging of portable electronic devices are explained. The core technologies adopted by the Wireless Power Consortium (WPC) for the “Qi” Standard in 2010 are summarized. Finally, the latest research and developments of wireless power transfer for midrange applications based on the domino-resonator concept and their future application potential are described.

Planar Wireless Charging Technology for Portable Electronic Products and Qi

A system for improved transcutaneous power transfer efficiency comprises a transmitter coil (20) applied to the outer surface of a cutaneous layer (24) on a patient's body by adhesive tape or other appropriate supporting material, and a receiver coil (22) implanted inside the patient's body. The transmitter coil and receiver coil include cores (28, 42) having pole faces (26a, 26b, 40a, 40b) with a substantially larger area than the cross section of the core at other locations. In addition, the core of the receiver coil (42) is substantially shorter than that of the transmitter coil (28) so that the lines of flux (54) produced by the transmitter coil tend to pass through the pole faces (40a, 40b) of the receiver coil in greater density than they would if the pole faces of the transmitter and receiver cores were spaced identically. The transmitter core (28) forms an angled portion adjacent each of the pole faces so that the main portion of the transmitter core (28) is disposed generally parallel, and closely spaced to the surface of the cutaneous layer (24) against which the transmitter core (28) is placed.

Electromagnetic coil configurations for power transmission through tissue

Improved organ function during cardiac bypass with a roller pump modified to deliver pulsatile flow.

Resection of aneurysms of the descending thoracic aorta using a GBH-coated shunt bypass☆☆☆

Diastolic augmentation by intra-aortic balloon. Circulatory hemodynamics and treatment of severe, acute left ventricular failure in dogs.

Artificial organs which are to be chronically implanted require a means of getting power into the body from an external power source with minimum risk of infection and irritation to the skin. The skin tunnel transformer is such a device whereby high level electromagnetic energy can be transmitted through the skin with very low losses and noncritical positioning. Two versions of the transformer are shown and described, and experimental results obtained with dogs are presented. Transmission over 50 watts at better than 95 percent efficiency has been accomplished with no ill effects. The use of the transformer for simultaneous transmission of telemetry data is also discussed.

Stephen R. Topaz

Papers

Improved organ function during cardiac bypass with a roller pump modified to deliver pulsatile flow.

Resection of aneurysms of the descending thoracic aorta using a GBH-coated shunt bypass☆☆☆

Diastolic augmentation by intra-aortic balloon. Circulatory hemodynamics and treatment of severe, acute left ventricular failure in dogs.

The Skin Tunnel Transformer: A New System that Permits Both High Efficiency Transfer of Power and Telemetry of Data Through the Intact Skin

The use of autogenous peritoneum for heart valve replacement