Skip

You make my heart go to 12,000 RPM
March 11, 2012 4:07 PM   Subscribe

"Nature is not always the best designer, at least when it comes to things that humans must build and maintain. So the newest artificial heart doesn’t imitate the cardiac muscle at all. Instead, it whirs like a little propeller, pushing blood through the body at a steady rate. After 500 million years of evolution accustoming the human body to blood moving through us in spurts, a pulse may not be necessary. That, in any case, is the point of view of the 50-odd calves, and no fewer than three human beings, who have gotten along just fine with their blood coursing through them as evenly as Freon through an air conditioner."
posted by Brandon Blatcher (104 comments total) 50 users marked this as a favorite

 
Read this in the print edition earlier. It's absolutely fascinating, especially when they interview the woman who hasn't had a pulse in years.
posted by Atreides at 4:11 PM on March 11, 2012


Halloween just got more exciting.
posted by arcticseal at 4:17 PM on March 11, 2012 [4 favorites]


Don't know if any other Australians are having a problem with the link, but there seems to be an automatic redirect that takes you to popsci.com.au, where the path is slightly different. The article can be found here.
posted by Ritchie at 4:26 PM on March 11, 2012 [1 favorite]


This makes me wonder what happens if you turn up the pump speed a lot whilst running to speed up oxygen circulation. I'd imagine the increased force could cause damage if pronounced enough, but that's a lot of bloodflow to get haemoglobin to the muscles.

In a similar vein, is the possibly resultant increased vo2 max cheating?
posted by jaduncan at 4:27 PM on March 11, 2012


This was all explained much better by Jeff Goldblume in Threshold. I just wish I could find the clip. Why I remember a scene from an unremarkable 30 year old movie but can't find my car keys from this morning is another medical mystery entirely.
posted by humanfont at 4:31 PM on March 11, 2012 [3 favorites]


jaduncan - i was wondering the same thing. as a cyclist who frequently pushes myself into oxygen defecit i'm always thinking about ways of increasing oxygen uptake. interesting....
posted by photoslob at 4:33 PM on March 11, 2012


Once the basic problem is solved -- which it appears to be just on the edge of -- all sorts of enhancements will inevitably follow. A microprocessor that measures O2 sat, and increases the pressure to accommodate (up to some reasonable maximum) for people jogging or running, working out, going up stairs, hiking at high altitude. And then the further enhancements, such as perhaps a device that can provide differential pressures to the ascending and descending aorta -- for example a person running doesn't need to have higher blood pressure in their brain....

In the spirit of speculation, what sort of non-obvious things can be done with this technology? What might be some unintended consequences (aside from the further geriatricization of the demographic makeup of society)?
posted by chimaera at 4:36 PM on March 11, 2012 [2 favorites]


Dick Cheney has no pulse thanks to his cardiac pump installed last year. He also has no soul, but he came that way originally, not due to any medical intervention.
posted by briank at 4:39 PM on March 11, 2012 [44 favorites]


It's absolutely fascinating, especially when they interview the woman who hasn't had a pulse in years.

Her heart is just sitting there, not doing anything! No pulse and everything is just fine, fucking unreal!
posted by Brandon Blatcher at 4:40 PM on March 11, 2012 [1 favorite]


jogging or running, working out, going up stairs, hiking at high altitude.

I'm trying to wrap my primitive meat brain around whether this would render cardiovascular exercise obsolete. I mean, there are fitness benefits, but would this preclude the necessity of exercise for people who just wanna be reasonably healthy and not have a heart attack?
posted by cmoj at 4:50 PM on March 11, 2012 [1 favorite]


This blew my mind. Thanks!
posted by troublesome at 5:02 PM on March 11, 2012


I wonder if they wear some sort of bracelet to alert EMTs that they aren't supposed to have a pulse.
posted by XMLicious at 5:05 PM on March 11, 2012 [5 favorites]


Boy you could really freak out some nurse that had just seen the latest vampire flick.
posted by sammyo at 5:06 PM on March 11, 2012 [2 favorites]


This is completely blowing my mind. How does this effect general health, particularly as people age? Do other parts of the body need that ebb and flow from a heart beat? Does the steady stream impact healing from cuts and if so how? How do paramedics tell with no pulse? Heart disease is a major cause of death, does this method extend life?

My mind is boggled with wonder.
posted by Brandon Blatcher at 5:13 PM on March 11, 2012 [3 favorites]


I'm so used to being able to feel/hear my heartbeat when I wake up in the middle of the night. It must be incredibly freaky to not and yet have everything be okay.
posted by rmd1023 at 5:14 PM on March 11, 2012


@XMLicious: probably the battery pack connected to wires going into their chest serves that purpose fairly adequately.
posted by lastobelus at 5:14 PM on March 11, 2012


@XMLicious: probably the battery pack connected to wires going into their chest serves that purpose fairly adequately.

Wait until it's a nuclear battery, much smaller, and fits in the space that used to be taken up by the rest of the heart.
posted by jaduncan at 5:17 PM on March 11, 2012


I thought that way back in the 1960's when they were first looking at this problem, they did try continuous flow, and came to the conclusion that a pulse was necessary. Among other things, without a pulse, the subjects tended to have kidney problems.
posted by Chocolate Pickle at 5:17 PM on March 11, 2012


I wonder if they wear some sort of bracelet to alert EMTs that they aren't supposed to have a pulse.

Yeah, you guys can put away the stake and the garlic. Really.
posted by greatgefilte at 5:18 PM on March 11, 2012 [3 favorites]


Dick Cheney has no pulse thanks to his cardiac pump
Cover story.
posted by Flunkie at 5:19 PM on March 11, 2012 [5 favorites]


what's so weird about not having a heartbeat? It seems obvious that it would be significantly less likely for turbines to evolve, so it is quite plausible that a turbine could be more reliable & efficient. (IE, if something seems no less likely to evolve and hasn't it usually is not worth exploring as an alternative -- the evolutional record is "telling" you that it isn't as good)
posted by lastobelus at 5:21 PM on March 11, 2012


This is completely blowing my mind. How does this effect general health, particularly as people age? Do other parts of the body need that ebb and flow from a heart beat? Does the steady stream impact healing from cuts and if so how?

If I remember correctly, once the blood gets to the level of the teeny-tiny capillaries, the flow is mostly continuous, rather than pulsatile, so theoretically there shouldn't be a problem. That said, I'm curious about Chocolate Pickle's comment referring to kidney problems as a result of continuous flow. Any references, CP?
posted by greatgefilte at 5:27 PM on March 11, 2012 [2 favorites]


This makes me wonder what happens if you turn up the pump speed a lot whilst running to speed up oxygen circulation. I'd imagine the increased force could cause damage if pronounced enough, but that's a lot of bloodflow to get haemoglobin to the muscles.

Fun fact: during intense physical activity your muscles can scale up the rate of blood flow through them by a factor of 60. That's why you sometimes get a pain in your right side when you run to the edge of your endurance. Other organs are being deprived of flow and when it happens to your liver it hurts.

The real question is can we make anything that will fit in the same cavity as a heart which will actually keep up with peak demand?
posted by clarknova at 5:33 PM on March 11, 2012 [7 favorites]


The link doesn't work in Australia, because the people who own Popular Science here hate their brand.
posted by Joe in Australia at 5:44 PM on March 11, 2012 [1 favorite]


How long until the un-heart can power itself with the sugars in the blood?
posted by LogicalDash at 5:46 PM on March 11, 2012 [1 favorite]


probably the battery pack connected to wires going into their chest serves that purpose fairly adequately.

How the heck would anyone know that the person they're looking at has an artificial heart that doesn't generate a pulse, out of all of the possible devices that require battery packs with wires going into your chest? I'm talking about a way for an EMT to know they don't need to be defibrillated, that the lack of pulse doesn't mean the heart has stopped. Like, I wonder if they show up as completely asystolic on an ECG or if an AED would decide to shock if it was hooked up to a person with one of these.
posted by XMLicious at 5:47 PM on March 11, 2012


@XMLicious: probably the battery pack connected to wires going into their chest serves that purpose fairly adequately.

Wait until it's a nuclear battery, much smaller, and fits in the space that used to be taken up by the rest of the heart.
posted by jaduncan at 19:17 on March 11 [+] [!]


There used to be pacemakers that ran off of nuclear batteries, but they fell out of favor for many reasons.
posted by ZeusHumms at 5:50 PM on March 11, 2012 [2 favorites]


My cousin once disconnected me, though, by mistake

That has to be worth a year's worth of baked goods at least.
posted by arcticseal at 5:52 PM on March 11, 2012 [2 favorites]


related

Sounds like we have quite a ways to go before we can get rid of the external battery.
posted by lastobelus at 5:54 PM on March 11, 2012


Is that a cappucino you're making or are you just happy to see me?
posted by hal9k at 5:56 PM on March 11, 2012 [2 favorites]


Cardiac medicine has just reinvented itself as a mash-up of the first three Tubeway Army/Gary Numan albums.

About time too, my electric friends.
posted by Devonian at 5:56 PM on March 11, 2012 [3 favorites]


Another exploration of this theme, lastobelus.
posted by jaduncan at 5:57 PM on March 11, 2012


"...what's so weird about not having a heartbeat? It seems obvious that it would be significantly less likely for turbines to evolve, so it is quite plausible that a turbine could be more reliable & efficient."

Sure, it's likely to be much more reliable and efficient. Biomechanics is fascinating and it is quite often that evolution finds extremely efficient solutions to problems. However, evolution doesn't produce efficient solutions in the absolute sense, only relative within the context of a particular environment of adaptation. Not only that, but it's very path-depedent—some solutions are far, far less efficient than they might have been merely because they're the result of a series of evolutionary events that basically cannot be unwound. And some things that are extremely efficient in one respect are not so efficient in many others, making it a not very efficient solution overall. (The wheel is a good example of all the things I've mentioned.) So, yeah, we can engineer all sorts of things which are more efficient and reliable than what's evolved, contrary to some opinion. But that doesn't mean that it necessarily wouldn't cause problems.

My concern is that I have an enormous difficulty believing that nothing evolved to take advantage of the pulse. I'd be willing to wager a significant sum of money right now, if I had it (which I don't) that eventually there will be found some biological process that is disrupted because of continuous blood flow. I say this as someone who is without question not inclined to ludditism—I'm all in favor of developments in medical technology like this, all else being equal.

That said, it's almost certainly preferable to the alternative for most patients who would need this. And whatever those side-effects might be, they could be mitigated.

In fact, I don't really see why these pumps couldn't produce a pulse, anyway. It may be in the specific design and materials of this iteration of the technology (they seem to spin at high RPM and the spin-up and spin-down can't be modulated quickly enough to produce a pulse), but I don't see that a different design using Archimedes screws with magnetic propulsion couldn't accomplish a pulse somehow. Not only that, but the processes I hypothesis to depend upon a pulse wouldn't necessarily rely upon the pulse as we know it—something like merely a periodic drop in pressure at intervals much longer than a heartbeat might accomplish all that's necessarily.
posted by Ivan Fyodorovich at 6:04 PM on March 11, 2012 [8 favorites]


Oh, and it's also possible, perhaps likely, that even if there are some processes which depend upon a pulse, that other sorts of wear-and-tear on the circulatory system and the organs wouldn't be reduced without these cyclic and relatively large pressure changes.
posted by Ivan Fyodorovich at 6:06 PM on March 11, 2012 [1 favorite]


One way to get around the how-will-EMTs know is to tattoo it on the patient's chest, and make checking for that tattoo part of EMT training. Wouldn't have to be words, just an agreed-upon symbol. Or even on the neck, if you worried about someone not seeing it under heavy chesthair or something.

Then you would only be in danger if you got one of these and traveled back in time, had a heart attack after they invented defibrillators, and EMTs didn't know about the symbol yet.

But everything has some risks.
posted by emjaybee at 6:13 PM on March 11, 2012 [3 favorites]


For the australians, i suspect this might be a teaser for the same article.
posted by jcm at 6:15 PM on March 11, 2012


My concern is that I have an enormous difficulty believing that nothing evolved to take advantage of the pulse.

The heartbeat seems to be for the heart. In between beats, it takes in nourishment. But yeah, it seems odd that lack of heartbeat wouldn't cause a negative effect somewhere.

In fact, I don't really see why these pumps couldn't produce a pulse, anyway.

As mentioned in the article, producing a pulse causes a lot of wear and tear on materials and nothing devised yet has been able to last more than 18 months. They have an example of the turbine that is in the artificial hearts which been operating nonstop for 8 years in the lab. The "evolutionary" choice here seems simple.
posted by Brandon Blatcher at 6:22 PM on March 11, 2012


Yeah, it's definitely possible that some body parts have evolved to, if not depend on the pulse, then to work synergistically with it, but in general a turbine seems more efficient and less likely to cause wear and tear, not just on the machinery, but on the body itself. I'm having trouble imagining out of hand a way in which a pump could properly compete with such a clearly superior solution to the problem.
posted by Navelgazer at 6:30 PM on March 11, 2012


For the australians, i suspect this might be a teaser for the same article.

Yup, just a teaser. Any other way for Australians to read this in full?
posted by vidur at 6:33 PM on March 11, 2012


According to my wife (who is in med school in the US), patients with these types of implants are supposed to wear bracelets informing EMTs that they do not have heartbeats.
posted by nolnacs at 6:34 PM on March 11, 2012 [1 favorite]


Keep the turbine as-is.

Put a balloon on the output.

Connect the balloon to the ventricle with a valve.

Turn the valve off and on again.

Repeat ~60 times per minute.
posted by LogicalDash at 6:35 PM on March 11, 2012


Really interesting story. This kind of tech is just unreal.

I wonder if you might eventually want to hook these guys up to respond to the normal endocrine network -- like speeding up the flow of blood if adrenaline is released. I also wonder whether it will eventually be necessary to make fake hearts send endocrine signals, also, like nitric oxide, or if there's enough redundancy that you can get away without it forever.
posted by en forme de poire at 6:36 PM on March 11, 2012 [1 favorite]


The balloon replaces the ventricle. It's connected to the aorta.
posted by LogicalDash at 6:37 PM on March 11, 2012


LogicalDash, that makes sense, but from the article:
Those balloons, and all other moving parts in a beating mechanical heart, wear out quickly. That’s why, almost 30 years after the first Jarvik-7, artificial hearts remain what is delicately termed “bridges to transplant”—something to keep you alive until a real heart can be found.
Your design isn't actually the same as the Jarvik-7, but I think the real problem is probably the same: finding elastic bits that don't constantly fail.
posted by en forme de poire at 6:39 PM on March 11, 2012 [3 favorites]


How long until the un-heart can power itself with the sugars in the blood?

I wonder if you might eventually want to hook these guys up to respond to the normal endocrine network


At this point you guys are talking awesome biotech science fiction.
posted by clarknova at 6:42 PM on March 11, 2012 [1 favorite]


Hm, since the design of the pump is similar to a fan, it wouldn't be bothered overmuch by some blood flowing the opposite direction, would it?

Just put a valve on, and no balloon.

Although come to think of it, valves need to move in two directions as well. That might... not hold up.
posted by LogicalDash at 6:43 PM on March 11, 2012


How long until the un-heart can power itself with the sugars in the blood?

Well, that depends on how much power the un-heart needs and how power can be extracted from sugars in the blood.

Will future patients need to eat foods high in sugar to help power their heart? Oh man!
posted by Brandon Blatcher at 6:45 PM on March 11, 2012 [1 favorite]


I'm seeing alot of people saying "why wouldn't X work?". You know, if you're curious about this subject - you can read the entire article. They address why X or Z has not worked in the past.
posted by Evernix at 6:46 PM on March 11, 2012 [1 favorite]


You guys, you're missing the big picture here. By which I mean: could this finally be a cure for my fucking tinnitus?
posted by Lentrohamsanin at 6:54 PM on March 11, 2012 [6 favorites]


"I'm seeing alot of people saying "why wouldn't X work?". You know, if you're curious about this subject - you can read the entire article. They address why X or Z has not worked in the past."

No they don't. Previous designs have assumed the necessity of a heartbeat and have been built around the balloon-valve design. The Archimedes screw design discussed in this article was not intended to be an artificial heart, only to supplement an existing heart. It was only discovered after-the-fact that this design a) can substitute by itself entirely for a heart, and b) that there don't seem to be any ill-effects.

What no one has attempted, or at least not discussed in the article, is to design an Archimedes screw type pump that includes some form of pulse. Contrary to BB's response, my mention of pulsing a screw pump does not have the inherent wear-and-tear problems as does the other designs. I'm guessing, as I wrote, that this hasn't been attempted, or cannot work, with this particular iteration of the technology because of the small-size/high-RPM nature of this particular screw pump, in conjunction with its magnetic motive and controller technology. Altering one or more of those components could produce a screw pump that pulses without adding any mechanical complexity at all. There would be a small increase in mechanical stress in the screw, but I assure you that this is not the stress discussed in the article. That stress has to do with valve-and-balloon technology.
posted by Ivan Fyodorovich at 7:08 PM on March 11, 2012 [1 favorite]


What no one has attempted, or at least not discussed in the article, is to design an Archimedes screw type pump that includes some form of pulse.

Why would they, if "there don't seem to be any ill-effects"?
posted by Brandon Blatcher at 7:16 PM on March 11, 2012




"Why would they, if 'there don't seem to be any ill-effects'?"

For the reasons we've already discussed. This apparent lack of ill-effects is extremely tentative—it's not as if there've been any controlled studies to determine this. Given the health of the patients involved, it's also likely that some or many ill-effects, if they exist, would be hidden by preexisting health problems. And intuition suggests to me, anyway, that some or most ill-effects would likely manifest systemically as chronic illnesses, whose etiologies would be very difficult to discern.
posted by Ivan Fyodorovich at 7:27 PM on March 11, 2012


Like the doctor's magic tricks, this story is a lot of sensationalist handwaving and a little reality. The few people whose hearts have stopped and continued to live long-term are the exceptions. Yes, the technology is amazing, however it is still years from the level that the article implies. The problems of continuous flow versus pumped still requires research.

I should know, I've been there and done that.
posted by Ardiril at 8:17 PM on March 11, 2012 [7 favorites]


I wonder if they wear some sort of bracelet to alert EMTs that they aren't supposed to have a pulse

When I was a 911 Emergency Medical Dispatcher, we received written notification that a named person residing at an address would not have a pulse due to a medical device. We had to enter that information in our database and anytime that address came up in our system, we were alerted to the "special notation" and passed that information to the responding medics.
posted by JujuB at 8:18 PM on March 11, 2012 [2 favorites]


"Another life to live" - How fucking corny!!!
posted by Ardiril at 8:32 PM on March 11, 2012


...could this finally be a cure for my fucking tinnitus?

Na, it's the damn hardening of the eyeballs. Presbyopia sucks. I want new eyeballs. Eyeballs that whirl around.
posted by BlueHorse at 9:04 PM on March 11, 2012 [1 favorite]


BlueHorse: "...could this finally be a cure for my fucking tinnitus?

Na, it's the damn hardening of the eyeballs. Presbyopia sucks. I want new eyeballs. Eyeballs that whirl around.
"

All of the above here. Except I want night vision and zoom. Seamless chrome would work, although I would take my steel blue.

Fuck Zeiss Ikons and the logo on the iris.
posted by Samizdata at 9:22 PM on March 11, 2012 [4 favorites]


For those who want to read the whole original article and can't because of PopSci's geolocation redirect (no images though).

I seem to recall that the pulse is responsible for a reasonable amount of total lymphatic flow, so I'd be curious to see if there's any noticeable effects there. Probably it's still better than the effect of congestive heart failure on lymph flow. And, IvanF, you might be be surprised how much additional wear to the bearings and shaft would result from pulsing the speed.
posted by Pinback at 10:24 PM on March 11, 2012


Ardiril, if you're claiming to be Tim Volk from that story, it's pretty obvious what the deal is there.

"Volk’s had several heart attacks, two surgeries to do multiple bypasses of blocked arteries and stents put in other blocked arteries. And still, just months after his last surgery, he was experiencing chest pain and shortness of breath. “He’s a very smart guy and he takes his medications well. He just has genetics we don’t understand,” said Dr. Joshi."

Also, you have not had the LVADs that were mentioned in the OP installed; you have had some other model and brand.
posted by Bonky Moon at 10:47 PM on March 11, 2012 [1 favorite]


"And, IvanF, you might be be surprised how much additional wear to the bearings and shaft would result from pulsing the speed."

Yeah, but I'm still pretty sure that the wear-and-tear discussed was about the balloon designs, not these. Also, did you note that the torque isn't delivered in this via direct coupling to the shaft, but rather electromagnetically through the housing to the outer edge of the screw to embedded rare-earth magnets? Which might be worse with regard to varying the speed and causing stress on the screw blades, come to think of it.
posted by Ivan Fyodorovich at 10:51 PM on March 11, 2012


I'm sure this is just taking us further down the rabbit hole, but if there is indeed a circulation problem for lymph then it would make sense to implant similar devices to propel lymph along. There is less lymph than blood, and it flows at a slower rate, so a lymph-pumping setup has potential to be relatively low-power. Something low-rpm would probably do the trick quite nicely.

It's too bad that it would be impractical to implant large batteries inside of the body. If you could do that you'd be able to have something similar to the Powermat in your bed or whatever.
posted by Bonky Moon at 10:59 PM on March 11, 2012


chimaera writes "In the spirit of speculation, what sort of non-obvious things can be done with this technology? What might be some unintended consequences (aside from the further geriatricization of the demographic makeup of society)?"

One big benefit of this is it seems to eliminate many of the bad things that happen when you have high blood pressure. I wonder if some day we'll see people at risk of stoke getting turbine hearts. Also it'll sure make an interesting debate once these become mainstream enough to be installed in athletes. Besides the obvious advantage of potential increased flow with oxygenation being restricted by lung function you'd have the advantage of not having to spend energy pumping the heart.

LogicalDash writes "Although come to think of it, valves need to move in two directions as well. That might... not hold up."

Lots of valves are rotary in action and could be designed to turn only one direction. See for a simple example the rotary disc shutter. Similar designs exist for ball valves that would greatly reduce the wear on the sealing surface.

Ivan Fyodorovich writes "Which might be worse with regard to varying the speed and causing stress on the screw blades, come to think of it."

Even just varying the speed is going to put additional strain on the thrust bearings/bushings and it'll flex the blades of the turbine. Plus I'm guessing it would increase the power requirements.
posted by Mitheral at 11:13 PM on March 11, 2012


"Nature is not always the best designer, at least when it comes to things that humans must build and maintain. So the newest artificial heart doesn’t imitate the cardiac muscle at all. Instead, it whirs like a little propeller, pushing blood through the body at a steady rate.

I've seen Jurassic Park. Jeff Goldblum would say this won't end well.
posted by karathrace at 11:34 PM on March 11, 2012


@Ivan Fyodorovich:

I'd be willing to bet a thousand$ or so that the non-pulse hearts result in lowered risk for stroke.
posted by lastobelus at 11:42 PM on March 11, 2012


"you have not had the LVADs that were mentioned in the OP installed" - No kidding, and plenty of other contenders are out there as well.

Also, Endocrine cells and blood vessels work in tandem to generate hormone pulses: "The pulsatile pattern of secretion of most hormones, resulting in burst like or episodic increases in circulating concentrations, is necessary for the generation of an appropriate downstream physiological response as well as the regulation of target cell function in both health and disease (Wildt et al. 1981, Matthews et al. 1983, Giustina & Veldhuis 1998, Robinson & Hindmarsh 1999)."

Basically, some systems work better with pulsed concentrations than when uptake sites are presented with a steady concentration.
posted by Ardiril at 11:54 PM on March 11, 2012


"Before installing an artificial heart, surgeons must remove the real one."

Then the beating heart is locked in an iron strongbox, and the key hidden in a nest at the top of a tree on the jagged cliffs of an island in a freezing lake in a dark forest that is seven miles from nowhere and seventy miles from anywhere else, a place where love will never find it.
posted by -harlequin- at 12:09 AM on March 12, 2012 [5 favorites]


"a place where love will never find it" - but not escape from a determined thief.
posted by Ardiril at 12:14 AM on March 12, 2012


amazing article, thanks
posted by 5_13_23_42_69_666 at 12:50 AM on March 12, 2012


When I get my mechanical heart I will ask that they set the rhythm of the blood coursing through my veins to a fiery and lustful tango beat. I will tango my way through the world like a tangoing fool who loves to tango and tangos everywhere he goes...

I will seduce many beautiful women with my mechanical tango heart. A bloody red rose clasped between my teeth.

Yes, it is my wish.
posted by Skygazer at 2:20 AM on March 12, 2012 [4 favorites]


> When I get my mechanical heart I will ask that they set the rhythm of the blood coursing through my veins to a fiery and lustful tango beat.

Cat?
posted by lucidium at 3:52 AM on March 12, 2012 [1 favorite]


The few people whose hearts have stopped and continued to live long-term are the exceptions.

The article noted that.

Yes, the technology is amazing, however it is still years from the level that the article implies.

The article quoted the doctor as saying it was at least 10-11 years before the un-heart could be ready.
posted by Brandon Blatcher at 4:11 AM on March 12, 2012


I'm interested in how they would do lungs. If aren't forced to create a device that inflates and deflates, what could an artificial lung look like?
posted by Ritchie at 4:47 AM on March 12, 2012


Ritchie, this could be of possible interest.
posted by Brandon Blatcher at 5:41 AM on March 12, 2012


BlueHorse: "...could this finally be a cure for my fucking tinnitus?

Na, it's the damn hardening of the eyeballs. Presbyopia sucks. I want new eyeballs. Eyeballs that whirl around.
"

Uh, tinnitus is ringing of the ears...

Bonky Moon: "Ardiril, if you're claiming to be Tim Volk from that story, it's pretty obvious what the deal is there."

You haven't been here long, have you?
posted by IndigoRain at 6:00 AM on March 12, 2012


The almost complete lack of skepticism towards the claims or the framing of the Popular Science article displayed here is absolutely fascinating. Here's a short list of what I see in the article and the discussion:

1) A bias towards "tech" as opposed to biology. Popular Science and magazines like it have been fantasizing about a Jetsons future for decades, and a Jetsons future that had a very strong bias towards hard engineering solutions. The more chrome, the better.

2) A bias towards artifice as opposed to nature (or processes not "rationally" designed by humans", which also, almost providentially, acts as a rejoinder to those who point to amazing qualities of reality as evidence that an Intelligent Designer designed them).

3) A touching faith in the power of instrumental reason to make everything better with no worry about externalities or unintended consequences. Very pre-World Wars.

4) A bias towards technical solutions that cost a lot of money - much, if not most, heart disease can be prevented long before an artificial heart is necessary through simple changes in diet and exercise.

5) A lack of interest in the socioeconomic context of this technology. Technology isn't disconnected from society - so what does this mean in terms of social justice? Who can afford it (not just within nations, but globally)? Who is first in line?

6) An idea of nature, of reality-with-a-capital-R as something oppressive that is to be feared and subdued. Maybe death isn't something that's always meant to be desperately raged against. Maybe it's part of life.
posted by jhandey at 6:30 AM on March 12, 2012 [1 favorite]


jhandey, it sounds like your first fpir issues can be combined into one: You seem disturbed by artificial means of prolonging or fixing health issues. That's fine, but it doesn't address the issue of people who are having problems right now.

For 5, it's strange that you're focusing on the lack of mention of social justice, when several comments have speculated about how this device could completely change various aspects of life, both for those who have it implanted and those that have to deal with the implantees. It reads like you have tunnel vision, where if people aren't discussing what you feel is important, than it's not really important.

Not sure what you're talking about with number 6.
posted by Brandon Blatcher at 6:54 AM on March 12, 2012 [1 favorite]


3) A touching faith in the power of instrumental reason to make everything better with no worry about externalities or unintended consequences. Very pre-World Wars.

Uh, half the thread seems to be discussion about whether the lack of beating will be a problem and then a bunch of arm chair engineering debating solutions to beating if the lack is actually a problem.

4) A bias towards technical solutions that cost a lot of money - much, if not most, heart disease can be prevented long before an artificial heart is necessary through simple changes in diet and exercise.

Well a) the alternative (donor heart) is essentially unavailable at any price and b) even if 95% of heart problems that would be solved with this technology could be avoided long term with diet and exercise your still talking a lot of people who would be helped.
posted by Mitheral at 7:20 AM on March 12, 2012 [2 favorites]


I can't wait for the Steampunk version that's coal-fired.
posted by dr_dank at 7:23 AM on March 12, 2012


Interesting article, but it doesn't really do justice to all of the work that has gone on in this field, and like most medical reporting contains some factual errors. For example, the Jarvik-7 wasn't the first artificial heart used in a human. Particularly ironic is that Denton Cooley implanted that heart at the same medical center where the doctors in the article work. Also, a caption in the article states: "Before installing an artificial heart, surgeons must remove the real one.", which is not always true. Here is a decent overview of available circulatory assist devices, some of whic work with the patient's own heart.

Keep the turbine as-is.

Put a balloon on the output...



I have actually seen intraortic balloon pumps used in that fashion, in cases where (as mentioned upthread) there was concern about maintaining pulsatile blood flow to the kidneys.

Something tey don't really address in the article is the problem of blood clots forming; blood really doesn't like to be exposed to surfaces other than endothelium, and anticoagulating patients sufficiently to avoid problems with strokes and other manifestations of blood clotting inappropriately while preventing bleeding complications can be very difficult. The surfaces that come into contact with the blood have gotten better over the years, but there is still room for improvement.

Overall, there is a lot of progress that has been made in this area in the last few decades, though.
posted by TedW at 7:25 AM on March 12, 2012


and no fewer than three human beings

This construction really bothers me. Is it three? Is it more than three? 50-odd cows I get, but if you're not rounding like that, then don't be coy.
posted by headnsouth at 7:29 AM on March 12, 2012


Secret or confidential patients?
posted by Mitheral at 7:38 AM on March 12, 2012


I caught those, Brandon, but the breathless style of the article's writing seems to have wiped them from the perceptions of other commenters. Not surprising, these docs need massive amounts of cash as Medicare and private health insurance resist paying for experimental procedures, and many have become as slick as used car salesmen in pitching their pet solutions. You will (almost) never catch them telling a full-out falsehood, but they do know all the weasel words. Stick a friendly reporter within their sphere and they go into god-mode.

If you want to write an enlightening article on the day-to-day cardio medicine industry, follow the money. Many hospitals cannot afford to lease the technology, instead they provide the space for it and private interests provide the instruments. Also, when a hospital builds a new cardiac wing, check out who underwrites the loan. Sure, a bank will be at the top of the heap but dig deeper and quite often you will find a local cardiology group putting up a shit-ton of money. Often, the same one with the Siemens contract.
posted by Ardiril at 8:50 AM on March 12, 2012


I like how they envision folks getting these from Costco and getting them stuck in. This will obviously free the path for folks who want (and once transplants are fully privatized due to the new technology, will the only ones with the credit scores to qualify for) actual hearts: people who wouldn't be caught dead at Costco. Of course, the heart can be as cheap as you like; the Heartmate LifeBattery(TM) is probably where the real cash is.

You all know, deep in your Archimedes Screws, that this is exactly how this is going to turn out.
posted by mobunited at 8:50 AM on March 12, 2012



Nature is not always the best designer, at least when it comes to things that humans must build and maintain. So the newest artificial heart doesn’t imitate the cardiac muscle at all.


See also: ornithopters.

There used to be pacemakers that ran off of nuclear batteries, but they fell out of favor for many reasons.

"Atom heart mother named" -- Evening Standard, 18 July, 1970.
 
posted by Herodios at 8:59 AM on March 12, 2012


2) A bias towards artifice as opposed to nature (or processes not "rationally" designed by humans", which also, almost providentially, acts as a rejoinder to those who point to amazing qualities of reality as evidence that an Intelligent Designer designed them).

wat
posted by en forme de poire at 9:02 AM on March 12, 2012


I caught those, Brandon, but the breathless style of the article's writing seems to have wiped them from the perceptions of other commenters.

Because it's pretty amazing? I'm not sure what your point is here. Will more testing have to done? Sure. Will this device be ready next year? Hell no. Will it even work long term? No one knows yet.

But still, it's pretty amazing.
posted by Brandon Blatcher at 9:19 AM on March 12, 2012


This makes me wonder what happens if you turn up the pump speed a lot whilst running to speed up oxygen circulation. I'd imagine the increased force could cause damage if pronounced enough, but that's a lot of bloodflow to get haemoglobin to the muscles.

jaduncan, you do realize that the peak flow from a continuous artificial pump is still lower than a "heartbeat" cycle pump, for the same flow rate?

IOW, the continuous "heartbeatless" pump will provide less strain on the vessels than your own natural heart would.
posted by IAmBroom at 10:20 AM on March 12, 2012


Back when my micropreemie had his episode with PIE, they switched him to an oscillating ventilator-- instead of giving him breaths it basically shimmied that air in there with a high rate of oscillating micro-breaths. Sort of. It was loud and scary but it worked.
posted by norm at 12:21 PM on March 12, 2012


Jeez. My first reaction on hearing this news was 'wouldn't it be funny if Cheney had one of these?'.

Well, yes, it is.
posted by Anything at 12:35 PM on March 12, 2012


This may be OT, but when people are getting new, turbo-charged hearts, I want new retinas, dammit. They're deteriorating from a congenital condition.

I want night vision and X-ray vision.

The structure of the retina is one of the most notorious arguments for the existence of evolution and non-existence of "intelligent design."
posted by bad grammar at 5:50 PM on March 12, 2012 [1 favorite]


Slightly bizarrely, the Australian article (ta Ritchie) is gently rewritten from the original (Pinback's google translate version) so that US heart disease numbers are replaced with Aussie, and the "two pound barbell" is put into proper units. And the journalist still provides a personal voice to Australina readers, despite probably being an american.

I'm sure this happens all the time, but it's still interesting when it's noticed.
posted by wilful at 6:28 PM on March 12, 2012


I'm a paramedic and have encountered this technology in the field. In our system, we're made aware of patients with Left Ventricular Assist Devices through our communications center, and this information comes up automatically on our computer displays when a call is dispatched at the patient's address. Since LVADs are a bridge to transplant, the transplant coordinators tend to be very proactive about raising awareness of the part of emergency providers. There are several different types of LVADs out there, and emergency procedures can differ markedly between them. One older variety could, in the event of a battery or equipment failure, be hand-pumped with an external squeeze bulb. One patient made the rounds of continuing education classes, showed off his system, and culminated the presentation by disconnecting the power source and pumping his own heart by hand. Then, in an amazing display of trust, he allowed others to step forward and pump the device for a while. The screw-type device, though newer, don't have that option.

I can't quite express how bizarre and unsettling it is to place a stethoscope to your patient's chest and hear a noise that sounds like the refridgerator compressor inside their body. It's also a little troubling to know that the patient could essentially die, and that little device would keep cranking along, unanaware of the grotesque futility of its continued operation. Since the system works in tandem with the patient's (often ineffective) heart, we can still get a ECG on such patients, but it only shows the electrical activity in the cardiac tissue, which has little to do with the patient's actual circulation.

One extremely important consideration for these patients is that in an emergency, they have to travel with enough specialized batteries to get them where they're going. After loading a critical LVAD patient on to a helicopter for flyout, I looked around my ambulance at the mess that follows a serious call... and felt my own heart skip a beat as I spotted the pile of backup batteries. Fortunately, we had enough time to get them on the flight with the patient. That person later received a new heart, and the coordination between EMS and the transplant system was promoted as a model of interagency operation. That was nice, because something rare and exceptional like that does not make for a stress-free call.
posted by itstheclamsname at 7:20 PM on March 12, 2012 [8 favorites]


1) A bias towards "tech" as opposed to biology. Popular Science and magazines like it have been fantasizing about a Jetsons future for decades, and a Jetsons future that had a very strong bias towards hard engineering solutions. The more chrome, the better.

2) A bias towards artifice as opposed to nature (or processes not "rationally" designed by humans", which also, almost providentially, acts as a rejoinder to those who point to amazing qualities of reality as evidence that an Intelligent Designer designed them).


You have this ass-backwards. People are excited not by the thought of replacing meat with metal, but at the sheer mind-bogglinglyness that such a counter-intuitive thing as beatless metal man-made heart might, in some sense of the word, be workable.

I think the bias on display here is towards nature, not away from it. Having your assumptions turned on their heads, and trying to figure out the ramifications of those things, is a very stimulating thing, and this thread is a result of that stimulation. It makes no sense to think about it without being open-minded about it - the sheer audacity of the concept demands being open minded just to accept that the doctors aren't crazy for thinking it could become real. You're mistaking a lot of that as most of your perceived bias.
posted by -harlequin- at 9:16 PM on March 12, 2012


wilful: "Slightly bizarrely, the Australian article … is gently rewritten from the original … so that US heart disease numbers are replaced with Aussie, and the "two pound barbell" is put into proper units."

It's also ¼ to ⅓ the length of the original (ending before it gets to the interesting stuff), and finishes with an exhortation to either buy the dead-tree version or wait an indeterminate amount of time before you can read it online.

That's basically a corporate version of "I fail at the Internets", strictly enforced by IP geolocation redirection.

"I'm sure this happens all the time, but it's still interesting when it's noticed."

At least in this case, to give credit where it's due, they did make a definitely human and more than token attempt at re-contextualizing it for a local audience. It's more amusingly interesting when it obviously "ain't been touched by human hands" - like the one I saw the other day, where "about 10lbs" became "about 4.53592kg".

Usually, though, it's just fsck'n annoying…
posted by Pinback at 11:22 PM on March 12, 2012


Okay, not only does this make me think of Tony Stark, but the inventor LITERALLY built this from a box of scraps.
posted by greenland at 9:55 AM on March 13, 2012


"Oh, baby, yeah, I want you so bad. You are SO hot... Just a second, baby girl..."

leans over to the bedside table and grabs a small remote

"Oh, yeah, overdrive. I am SOOOOO ready for you baby...."
posted by Samizdata at 10:48 AM on March 13, 2012 [1 favorite]


leans over to the bedside table and grabs a small remote

Next door neighbor configures channel on Wifi Router


[Sad trombone sound...]



"Oh no, oh no!! Ahh. (Sighs) Damn baby, I'm sorry, I'm so into you. I don't know what happened...."
posted by Skygazer at 11:52 AM on March 13, 2012 [1 favorite]


"Really Herb? 6.000RPMs is all I do for you?"
posted by Brandon Blatcher at 12:17 PM on March 13, 2012


Brandon Blatcher: ""Really Herb? 6.000RPMs is all I do for you?""

No, baby, noooooooo... My tach needs calibrated, baby... Seriously...
posted by Samizdata at 8:06 PM on March 13, 2012


Why even have a single heart? Why not make a bunch smaller hearts distributed throughout the body, close to where they're needed? Between them and a Kevlar forehead no sniper could stop me!
posted by Ritchie at 5:28 AM on March 14, 2012 [2 favorites]


No, baby, noooooooo... My tach needs calibrated, baby... Seriously...

Don't lie to be Herb! We've been replacing batteries a progressively lower rate. Last year it was 4, before that 6. Don't you remember we use to go through 10 a year?!

What happened to us? Was it the Heart Mate IV upgrade, is that it?
posted by Brandon Blatcher at 5:41 AM on March 14, 2012


Brandon Blatcher: "No, baby, noooooooo... My tach needs calibrated, baby... Seriously...

Don't lie to be Herb! We've been replacing batteries a progressively lower rate. Last year it was 4, before that 6. Don't you remember we use to go through 10 a year?!

What happened to us? Was it the Heart Mate IV upgrade, is that it?
"

No, baby, no. It's just when I got the inductive charger upgrade. That's why I lie around with that plate on my chest.

I love you like I used to, baby. I'd say my heart belongs to you, beautiful, but we still haven't paid it off...
posted by Samizdata at 4:34 PM on March 16, 2012


"My cousin once disconnected me, though, by mistake,” she said. “I was showing her how to change the battery. She disconnected one, and then—I was distracted for a second—the other. I yelled, ‘You can’t do that!’ and then passed out.

"Oh, nothing, I'm just going into cardiac arrest, because you...just yanked it out like a trout!"
posted by nicebookrack at 9:58 AM on March 17, 2012


« Older "Two years before Hannah Arendt declared evil...   |   Few Examples of Lisp Code Typography Newer »


This thread has been archived and is closed to new comments



Post