A lot of the optimism in the discussion here is misguided. Late life heart failure and COPD has systemic roots and a heart transplant will be an expensive and painful way of living a diminished life for a short time (see discussion on constant blood pressure/gastro bleeds and LVAD side effects). Be active, keep your BMI low, and control your blood pressure. Prevention is by far the best approach. It is great news for younger patients suffering heart failure from infection damage, congenital defect, et al., though, particularly given the disgraceful lack of organ donors. Make sure you are an organ donor.
There are other measures being developed in this area with stem cell replacement therapy. A very common cause of late life heart failure is a depletion of stem cells and the heart eventually can't replace its own cells. There was an interview on Joe Rogan recently with a doctor that works in this area [1] [2]
Joe Rogan gives plausible sounds cranks a platform and an imprimatur in the interest of open mindedness. But he mixes it in with good sources of information. It may be for you if you want to be exposed to controversial ideas, but if you are not careful it will make you less informed on certain topics. Saying depletion of stem cells causes age related infirmity is basically a tautology, as is with telomere lengthening.
If this guy's ideas worked, he wouldn't be doing his work in Panama, hawking supplements, and appearing on Joe Rogan. He'd be among the wealthiest persons in the world. "Snake oil" works because you are selling a cure to desperate people, and fear of mortality is almost universal.
He operates out of Panama because U.S. laws don't allow the full use of all stem cell types yet. Stem cell therapy and CRISPR are going through various legal challenges. I would expect more innovation to occur in parts of the E.U. and Japan in these areas.
Keep your inflammation down as well, that is going to be far more of an issue than your BMI.
With regard to organ donors, the meth problem is causing all sorts of heart valve infections due to users injecting impure substances into their veins.
This, of course, is no issue for people in non-socialized medicine countries, but in places like Canada it puts a further strain on available hearts as the meth users end up being another drain on Cardiac resources.
To my knowledge, CRP has not been reliably identified as a marker for long-term inflammatory state monitoring without a clearly identified diagnosis such as connective tissue diseases.
Yes, I mentioned a couple. There are a few more (acute cardiac injury from CAD without comorbidities?) I didn't intend on being fatalistic or overly pessimistic. Not qualified nor intended as personal medical advice, but wanted to balance unrealistic optimism elsewhere in the thread.
This article is showcasing how far even the most bleeding edge technology from recreating the functionality of basic human organs. Heart doesn't seem exactly the most complex organ structurally wise, especially compared to things like lungs, liver, or kidneys. But we can't even make a sustainable replacement for it that wouldn't require 4 kilograms of external batteries that you'd need to recharge multiple times a day.
I can't wait for the future where artificial organs and limbs not only match the usability and functionality of the normal ones, but actually exceed it.
> But we can't even make a sustainable replacement for it that wouldn't require 4 kilograms of external batteries that you'd need to recharge multiple times a day.
There's no magical solution.
The heart develops several watts of mechanical power 24/7 [1], i.e. that's what is required even if the pump was perfectly efficient, and I doubt pumps are that efficient.
Right. The heart performs a bunch of chemical reactions to sustain its energy needs and the fact that in 2019 we don't have anything even remotely capable of doing the same at a scale required is kinda depressing.
> I can't wait for the future where artificial organs and limbs not only match the usability and functionality of the normal ones, but actually exceed it.
Why? What exactly would you do with those capabilities? Sit at a desk job and work 50 hours a week to make payments on your super organs and limbs?
You can already achieve great levels of performance with regular limbs and organs, and most people don’t take advantage of that, so I don’t see what artificial ones will add.
I read the article with great excitement and enthusiasm. The idea of contact-less rotor and dynamic positioning is IMO brilliant. However when I read the overview article on Wikipedia, my optimism was somewhat damped. Even the "ancient" model Jarvik-5 could a help a calf survive for 286 days, so the 90 days bovine-testing does not say much. Other prototypes had achieved even greater success in human trial but were later abandoned like the AbioCor design. OHSU has developed a simple design with contact-less shuttling pump similar to the concept of Bivacor but seem failed for clinical trial. Other design like the Carmat, the Polish POLVAD or the Taiwanese Phoenix-7 seem very promising too, but they obviously didn't make any breakthrough yet. AFAIK the bio-compatibility and the stability of the artificial heart are the most important factors. As auch, I think we're still years away when not decades away from a real breakthrough in artificial heart.
https://en.wikipedia.org/wiki/Artificial_heart
This is huge, though I have practical concerns. With two five hour batteries, how critical will degradation be? Are these custom batteries that become the new insulin?
How does this conflate with respiratory failure, which usually leads to cardiac failure? Will we presumedly need new EFR training to avoid frying this with an AED?
The batteries are outside the body, so replacing them is not a big deal.
> Are these custom batteries that become the new insulin?
Surgery to implant this machine will probably be in the $1 million range, new batteries are a rounding error on that.
> Will we presumedly need new EFR training to avoid frying this with an AED?
An AED looks for fibrillation before triggering, if it doesn't detect that it won't fire. Same for a Dr. - they look for fibrillation, they don't just randomly apply paddles like in the movies.
Most?? Most deductibles are under $5,500, you bet it exceeds it.
Did you mean policy limits? Those were made illegal recently (part of why healthcare costs went up so much).
> Batteries might not a few years down the road.
Doesn't matter. Someone with this device will have so much medical monitoring the cost of a battery won't be noticed. A battery will cost less than a single Dr. visit probably.
You misunderstand me. You'll be able to afford the heart because your insurance will pay for it.
A few years from now, you might not be able to afford that new $5,000 battery you need to RUN your heart.
> Someone with this device will have so much medical monitoring the cost of a battery won't be noticed. A battery will cost less than a single Dr. visit probably.
The same could be said about people with insulin pumps, yet we see financial problems kill them.
Heartbeat in artificial hearts is a problem, and a lot of thought and expenses are put into avoiding it. Both the pumping action, and the opening/closing of the valves, and also the blood flow disturbances cause damages to blood cell, and promote clotting. Nb, the later two are also relevant to artificial valves, which is why specialist materials & configurations are being used.
Any moving or flexing part is subject to wear and tear, and the risk of eventual breakdown, necessitating replacement surgery every few years. Open heart surgery is involved, somewhat risky, and puts the organism under significant stress by its very nature.
To the best of my (layman's) knowledge, pulse is not really needed by the body, and using smooth flow pumps causes no health risk. Of course there's the inability to check for the pulse or its tempo, as well as the mental impact of not having the expected sign of being alive.
"Patients will wear a 4-kg external controller pack that contains two rechargeable batteries (providing about 5 hours of operation each), although they can also plug in directly to a power outlet."
Usually these artificial hearts are to keep a person alive long enough for a donor to become available. Not a problem if they have to lug a battery around for a few months since it's not permanent.
My wonder is why it shouldn't be powered by the sugar in the blood just like every other organ. That's where a real miracle will lie. I understand issues with coagulation on silicon parts.
That's not entirely true. There are fuel cells which work by oxidizing blood. I can imagine that they are not efficient enough at this point, but it's a start.
My money is that we invent this to combat/manage people's weight. A machine that slowly burns off excess glucose in the blood stream? Suddenly those extra calories aren't a problem!
(There are probably a whole host of knock on effects that I'm not considering. I'm not a biologist.)
Very interesting idea. It’s been ages since I took chemistry but I’m not sure what to break down. Glucose is C6H12O6. If we imagined nanobots that could break this down in any way (disregarding latent energy) the most obvious compounds are 6 water + benzene (which causes anemia) or 6 hydrogen and carbon monoxide molecules (which causes hypoxia).
We could follow traditional glycolysis but without a recapture method, would cells create excess ATP? What would that affect? Would it change the production of insulin and it’s affects on storing tryglicerides? I barely have enough knowledge here to ask questions let alone have answers.
The most obvious option would be turning it into lactic acid right in the end of the kidneys. Any option you choose, people doing that would better drink a lot of water.
Anyway, I'm not sure breaking glucose is that useful. Won't it just make people hungry?
