医学专业英语课件_1

BuildingABetterHeartSecondChance:artificialheartQingYeDepartmentofCardiothoracicSurgeryRenJiHospitalMilestonesinartificialheart•1953,aheart-lungmachinedesignedbyDr.JohnGibbonisusedinasuccessfulopen-heartsurgery,demonstratingthatanartificialdevicecantemporarilymimicthefunctionsoftheheart•1955,ateamofscientistsledbyWillemKolff,testedtheirmodelinanimals•1964,theNationalHeart,LungandBloodInstitutesetsagoalofdesigningatotalartificialheartby1970•1966,Dr.MichaelDeBakeyofHoustonsuccessfullyimplantsapartialartificialheart•1967,Dr.ChristiaanBarnardperformsthefirstsuccessfulhumanhearttransplant.Thepatients,53-year-olddentistLouisWashkansky,dies18daysaftersurgeryinSouthAfrican•In1969,ateamledbyDentonCooleyoftheTexasHeartInstitutesuccessfullykeptahumanpatientaliveformorethansixtyhourswiththeirmodel(temporary).Thepatientgetsahearttransplantthreedayslaterbutthendies1½daysafterward•In1982,ateamledbyWilliamDeVriesoftheUniversityofUtahimplantedtheJarvik-7intoapatientnamedBarneyClark,whosurvivedwithJarvik-7for112days•1982-1985,Dr.WilliamDeVriescarriesoutaseriesoffiveimplantsoftheJarviktotalartificialheart•WilliamSchroeder,lived620days,dyinginAugust1986atage54•1994,theFoodandDrugAdministrationapprovestheLeftVentricularAssistDevice,whichhelpsfailingheartscontinuetofunction•2000,AmaninIsrealbecomesthefirstrecipientoftheJarvik2000,thefirsttotalartificialheartthatcanmaintainbloodflowinadditiontogeneratingapulse•2001,doctorsatJewishHospitalinLouisville,Ky.,implantthefirstself-contained,mechanicalheartreplacementintoapatient•Tworecipient:RobertTools&TomChristersonRobertJarvik•HewasborninMichiganonMay11,1946•In1964,hisfatherbecameillwithheartdiseaseandhadtohaveopenheartsurgeryRobertJarvik•Jarvikbecameveryinterestedinmedicineatthatpointandbegantothinkaboutpossibledesignsforartificialheartsthatcouldhelppeoplelikehisfather•HeinventedJarvik-7andJarvik-2000Jarvik-7Jarvik2000Prof.WillemJKolff•HewasborninLeiden,Netherlands•GraduatedfromtheUniversityofLeiden•In1955,heimplantedanartificialheartintoadog•TutorofDr.RobertJarvik•1981,heappliedtoFDADr.WilliamdeVries•AnAmericancardiothoracicsurgeon•ReceivinghisMDdegreefromtheUniversityofUtahin1970•Asaresidentincardiovascular/thoracicsurgeryatDukeUniversityMedicalCenter•AssistantprofessorofsurgeryattheUniversityofUtahuntil1984Dr.WilliamdeVries•Since1984,hehasbeendirectoroftheartificialheartprojectoftheHumanaHospitalAuduboninLouisville,Kentucky•PerformedthefirstsuccessfulpermanentartificialheartimplantforBarneyClarkbyusinganartificialdevicedesignedbyDr.RobertJarvikDr.BarneyClark•An61yearoldretireddentistfromSeattle•Firstrecipientoftheman-madeartificialheartonDec1,1982attheUtahMedicalCenterDr.BarneyClark•Sixyearsbeforethetransplant,hehadcontractedamysteriousviralinfection,whichmadehiscardiacmuscleflabby,weakandswollenfromalackofbloodflow•Becauseofhypertensionandhisage,hewasnotanacceptablecandidateatanyhearttransplantationcenterDr.BarneyClark•HewasintroducedbyhisprivatedoctortoDr.WillimDeVries•ThemeetingincludedvisitstolaboratorieswheretheJarvik-7wasmanufacturedandtheanimalbarnwheretheyobservedcalves/sheepwithsimilarheartimplants•Hewasgivenan11-pageconsentform•TherewasnoguaranteethattheoperationwouldincreaseClark’slifespan,noguaranteehewouldregainhisindependenceDr.BarneyClark•Theconsentformstated“Irecognizethatiftheartificialheartdevicefails,deathorseriousinjuryisthenearcertainresult.Ineverthelessaccepttheriskofsubstantialandseriousharm,includingdeath,implementationoftheartificialheartdevicecanbedemonstratedDr.BarneyClark•HesignedaconsentformonNov30,1982at9:52p.mafterbeinginterviewedbysixmembersofaspecialheartsubcommitteeatUniversityofUtahMedicalCenter•ThesurgerywasscheduledatthemorningofDec2,1982•However,hewasimmediatelyrushedintotheoperatingroombecauseofhisdeterioratingheartonDec1,1982at10:30p.m.Dr.BarneyClark•HesurvivedwithJarvik-7for112days•AseriousofcomplicationledtoClark’sdeathfromcirculatoryandmulti-organcollapseonMarch23at10:02p.m.TworecipientsofAbiCorartificialheart•RobertTools,firstrecipientofAbiCorartificialheartwasdiedfivemonthsafterimplantation,2001TworecipientsofAbiCorartificialheart•TomChristerson,secondrecipientofAbiCorartificialheartarestillaliveformorethanoneyearArtificialheartsabandoned•Bytheendofthe’80s,theJarvikdeviceshadbeenimplantedtosustainpatientswaitingfortransplants•Sincethen,developmentofanimprovedartificialhearthascontinued•Scientistscontinuetoworkondesignsforanartificialheartthatcouldprovidearealistic,permanentoptionforsurvival•JarvikisnowworkingontheJarvik2000,athumb-sizedheartpumpArtificialheartsabandoned•Universalinfection•Thromboembolism•TotalartificialheartmaybebetterusedasabridgetotransplantationLVADArtificialheart